中性粒细胞明胶酶相关脂质运载蛋白在妊娠期糖尿病患者中的表达及意义  

Expression and significance of neutrophil gelatinase-associated lipids in gestational diabetes mellitus

作　　者：王言言 尹晓茜 霍琰[2] 潘怡星 刘丽 刘素新[2] Wang Yanyan;Yin Xiaoqian;Huo Yan(Hebei North University,Zhangjiakou075000;Department of Obstetrics,Hebei General Hospital,Shijiazhuang050051)

机构地区：[1]河北北方学院研究生院,张家口075000 [2]河北省人民医院产科,石家庄050051

出　　处：《现代妇产科进展》2019年第5期325-328,共4页Progress in Obstetrics and Gynecology

基　　金：2016年政府资助临床医学优秀人才培养和基础课题研究项目(No:361003);脂肪细胞因子在妊娠期糖尿病发病中的作用研究(No:361003)

摘　　要：目的:探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在妊娠期糖尿病(GDM)患者血清、脐血及胎盘组织中的表达及其与新生儿体重的相关性。方法:选取2017年6月至2017年11月于河北省人民医院产科行剖宫产术的GDM患者49例、正常妊娠(NGT组)孕妇39例。ELISA法测定母血、脐血血清NGAL水平,RT-PCR及Western blot法测定胎盘组织中NGAL mRNA及其蛋白表达。结果:GDM组母血、脐血血清NGAL水平均高于NGT组,胎盘组织中NGAL mRNA和蛋白表达量高于NGT组,两组比较差异有统计学意义(P<0.01)。NGT组和GDM组孕妇血清NGAL水平与脐血均呈正相关(r=0.399,P=0.012;r=0.349,P=0.014);GDM组孕妇血清NGAL水平与胎盘组织NGAL mRNA(r=0.848,P=0.008)、蛋白(r=0.636,P=0.011)及新生儿体重(r=0.363,P=0.014)、胰岛素抵抗指数(r=0.312,P=0.044)均呈正相关。结论:GDM患者外周血NGAL水平的增加主要可能源于胎盘组织NGAL因子的过分泌,并通过增加胰岛素抵抗(IR)参与了GDM的发生。NGAL能通过胎盘转运至胎儿并进一步影响胎儿的宫内生长发育。Objective: To investigate the expression of neutrophil gelatinase-associated lipid carrier protein (NGAL) in serum,umbilical cord blood and placenta of gestational diabetes mellitus (GDM) and its correlation with neonatal weight. Methods: From Jun. 2017 to Nov. 2017,49 patients with GDM underwent cesarean section due to scar uterus and breech position in Hebei General Hospital and 39 age-matched normal controls were recruited.The levels of serum NGAL in maternal and umbilical blood were measured by ELISA.The expressions of NGAL mRNA and its protein in placenta tissue were detected by RT-PCR and Western blot. Results: The levels of serum NGAL in maternal and umbilical blood in GDM group were higher than those in NGT group,and the expression of NGAL mRNA and protein in placental tissue of GDM patients were higher than those in NGT group.The difference between the two groups was statistically significant ( P <0.01).There was a positive correlation between maternal NGAL level and umbilical cord blood in NGT group and GDM group[( r =0.399, P =0.012)、( r = 0.349 , P =0.014)].The maternal NGAL level in GDM group was positively correlated with the levels of NGAL protein in placental tissue ( r =0.636, P =0.011),mRNA ( r =0.848, P = 0.008 ),neonatal weight( r =0.363, P =0.014)and insulin resistance index ( r =0.312, P = 0.044 ). Conclusions: The increase of NGAL level in peripheral blood of GDM patients may be mainly due to the over-secretion of NGAL factor in placenta,and may participate in the development of GDM by increasing insulin resistance.NGAL can be transported through the placenta to the fetus and further affects the fetal intrauterine growth and development.

关 键 词：妊娠期糖尿病 中性粒细胞明胶酶相关脂质运载蛋白 胎儿宫内生长发育 

分 类 号：R320[医药卫生—人体解剖和组织胚胎学]