胰岛素信号通路在妊娠期糖尿病患者分娩巨大儿中的作用  

Study on the effect of insulin signaling on occurrence of macrosomia delivery by women with gestational diabetes mellitus

作　　者：商敏[1] 董旭 SHANG Min;DONG Xu(Department of Obstetrics and Gynecology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Obstetrics and Gynecology,Beijing Puren Hospital,Beijing 100062,China)

机构地区：[1]首都医科大学附属北京友谊医院妇产科,北京100050 [2]北京普仁医院妇产科,北京100062

出　　处：《临床和实验医学杂志》2018年第7期699-702,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市医院管理局培育计划项目(编号:PX2016060)

摘　　要：目的 探讨胰岛素信号通路在妊娠期糖尿病(GDM)患者分娩巨大儿中的作用。方法 前瞻性研究在首都医科大学附属北京友谊医院分娩的合并妊娠期糖尿病但血糖控制满意的20例足月单胎孕妇,其中10例分娩胎儿为巨大儿(胎儿体重≥4 000 g)纳入巨大儿组,另10例为同期年龄、体重配对的10例分娩正常体重胎儿(4 000 g>胎儿体重≥2500 g)纳入正常体重儿组。用免疫组化法测定胎盘胰岛素受体底物1(IRS-1)和葡萄糖转运蛋白(GLUT)-1和GLUT-3的表达,用RT-实时定量PCR法测定GLUT-1和GLUT-3的表达水平。结果 巨大儿组IRS-1、GLUT-1和GLUT-3染色强度均显著强于正常体重儿组(P<0.05),巨大儿组和正常体重儿组GLUT-1 mRNA表达量分别为2.10±0.43和1.17±0.89,GLUT-3 mRNA表达量分别为1.11±0.24和0.67±0.39,差异均有统计学意义(P<0.05),GLUT-1和GLUT-3的mRNA表达量与新生儿出生体重呈正相关(P<0.05),相关系数分别为0.877和0.820。结论 分娩巨大儿的妊娠期糖尿病患者胰岛素信号通路及GLUT-1和GLUT-3表达增强,与巨大儿的发生关系密切。Objective To explore the effect of insulin signaling on delivery of macrosomia in women with gestational diabetes mellitus(GDM).Methods Twenty singleton women with GDM had good glucose levels and delivered in this hospital,they were recruited in this prospective study.Ten of them delivered macrosomia(newborn birth weight≥4 000 g)and other ten of them were matched by ages,weight and delivered newborns with normal birth weight(4 000 g>newborn birth weight≥2 500 g,).The expression of insulin receptor substrate-1(IRS-1),glucose transporter1(GLUT-1)and GLUT-3 in placenta were detected by immunohistochemical method,the expression levels of of GLUT-1 and GLUT-3 were also measured by RT-real-time PCR method.Results The intensity of IRS-1,GLUT-1 and GLUT-3 was much stronger in placenta of macrosomia than in placenta of newborns with normal birth weights(P<0.05).The mRNA expression levels of GLUT-1 and GLUT-3 were 2.10±0.43 versus 1.17±0.89 and 1.11±0.24 versus 0.67±0.39 in placenta of macrosomia versus in placenta of newborns with normal birth weight(P<0.05)respectively.GLUT-1 and GLUT-3 mRNA were positively correlated with newborn birth weight(P<0.05).Conclusion The activated insulin signaling and increased expression of GLUT-1/GLUT-3 may be associated with delivery of macrosomia by women with gestational diabetes mellitus(GDM).

关 键 词：妊娠期糖尿病 巨大儿 胰岛素受体底物 葡萄糖转运体 

分 类 号：R714.256[医药卫生—妇产科学]