妊娠期糖尿病孕妇胎盘和大网膜脂肪组织TNF-α及IL-1β的表达及其与胰岛素抵抗的关系  

The Relationship between the Expressions of Tumor Necrosis Factor-α,Interleukin-1β and Insulin Resistance in Placenta and Adipose Tissue of Gestational Diabetes Mellitus

作　　者：徐玉红[1] 晋柏[1] 孙丽洲[1] 曹晓辉[1] 张晶[1] 

机构地区：[1]南京医科大学第一附属医院,江苏南京210029

出　　处：《实用妇产科杂志》2013年第10期745-748,共4页Journal of Practical Obstetrics and Gynecology

基　　金：江苏省"科教兴卫工程"妇产科医学重点学科基金(编号:XK201112)

摘　　要：目的:探讨妊娠期糖尿病(GDM)孕妇胎盘和大网膜脂肪组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)的表达及其与胰岛素抵抗的相关性。方法:采用荧光实时定量PCR检测20例GDM孕妇(GDM组)和20例正常孕妇(对照组)胎盘和大网膜脂肪组织中TNF-α、IL-1βmRNA的相对表达量,测定两组孕妇空腹血浆葡萄糖(FPG)、胰岛素(FIN)水平,计算出胰岛素抵抗指数(HOMA-IR),并进行相关性分析。结果:①与对照组相比,GDM组孕妇胎盘和脂肪组织中TNF-αmRNA的表达量升高,差异有统计学意义(P=0.01;P=0.01)。②两组孕妇胎盘和脂肪组织中IL-1βmRNA的表达比较,差异无统计学意义(P>0.05)。③GDM组孕妇胎盘和大网膜脂肪组织TNF-αmRNA表达水平与HOMA-IR呈明显正相关(r=0.54,P=0.01;r=0.61,P=0.01);对照组大网膜脂肪组织TNF-αmRNA表达水平与HOMA-IR呈明显正相关(r=0.52,P=0.02)。④两组孕妇胎盘和大网膜脂肪组织IL-1βmRNA表达水平与HOMA-IR均无明显相关性(P>0.05)。结论:胎盘和脂肪组织TNF-α的过度表达可能是GDM孕妇胰岛素抵抗的重要原因,IL-1β在胰岛素抵抗过程中发挥的作用并不明显。Objective：To investigate the relationship between the expressions of tumor necrosis factor-α （TNF-α） jnterleukin-1β（ IL-1β） and insulin resistance in placenta and adipose tissue in women with gesta- tional diabetes mellitus（GDM）. Methods：Real-time PCR was used to detect the expressions of TNF-α, IL-1β mRNA in placenta and adipose tissue in GDM women （GDM group,20 cases） and normal pregnant women （control group,20 cases）. The levels of fasting plasma glucose （ FPG）, fasting insulin （FIN） and insulin resistance index（HOMA-IR） in the two groups were measured and calculated. The relationship among the a- bove-mentioned indexes were analyzed. Results：（1）Compared to the control group,the expression of TNF-a mRNA was significantly higher in placenta and adipose tissue in GDM group（ P = 0. 01 ; P = 0.01 ）. （2）No difference was found in the levels of IL-1β mRNA between the two groups（ P 〉0. 05）. （3）In placenta and adi- pose tissue of GDM group, positive correlations were detected between the levels of TNF-α mRNA and HO- MA-IR（ r= 0.54, P = 0. 01 ; r = 0. 61, P = 0.01 ）, while in adipose tissue of control group, TNF-a mRNA was positively correlated with HOMA-IR（ r=0.52, P =0.02）. （4）No correlations were found in the expression of IL-1β mRNA and HOMA-IR in placenta and adipose tissue of both groups（ P 〉 0.05）. Conclusions： Overex- pression of TNF-α in placenta and adipose tissue might be one of the most important causes of insulin resist- ance in GDM women,the influence of IL-1β on the process of IR seems not clear.

关 键 词：肿瘤坏死因子 白细胞介素-1Β 妊娠期糖尿病 胎盘 脂肪组织 

分 类 号：R714.256[医药卫生—妇产科学]