妊娠期糖尿病TNF-α、VCAM-1表达及与胰岛素抵抗关系  

Expression of TNF-αand VCAM-1 in women with gestational diabetes mellitus and its association with their insulin resistance

作　　者：陶贝贝[1] 杨筱青[1] 郭华锋[1] 高亚丽 赵莉莉 TAO Beibei;YANG Xiaoqing;GUO Huafeng;GAO Yali;ZHAO Lili(Zhengzhou Maternal and Child Health Care Hospital, Henan Province, 450000)

机构地区：[1]河南省郑州市妇幼保健院,450000

出　　处：《中国计划生育学杂志》2020年第12期2102-2105,F0003,共5页Chinese Journal of Family Planning

基　　金：河南省郑州市普通科技攻关计划项目(20150180)。

摘　　要：目的:分析妊娠期糖尿病(GDM)患者血清及胎盘中肿瘤坏死因子-α(TNF-α)与血管细胞黏附分子-1(VCAM-1)的表达,探讨其与胰岛素抵抗(HOMA-IR)关系。方法:选取2017年1月—2019年6月本院GDM孕妇168例及正常孕妇200例为研究对象,按照OGTT时间-血糖曲线下面积(AUC)及HOMA-IR值将GDM组孕妇进一步分为AUC<15.7组(87例)及AUC≥15.7组(81例),HOMA-IR<2.2组(90例)及HOMA-IR≥2.2组(78例),应用酶联免疫吸附实验及免疫组化法检测血清及胎盘组织中TNF-α、VCAM-1的表达。结果:GDM组孕妇血清及胎盘TNF-α(2.97±0.76 ng/ml、0.17±0.04 OD)、VCAM-1(129.22±27.45 ng/ml、0.15±0.06 OD)表达均大于对照组,HOMA-IR(2.15±0.66)大于对照组(1.53±0.59)(P<0.001)。GDM组孕妇中,AUC≥15.7组孕妇血清及胎盘TNF-α、VCAM-1表达大于AUC<15.7组孕妇,HOMA-IR大于AUC<15.7组孕妇(均P<0.05);HOMA-IR≥2.2组孕妇血清及胎盘TNF-α、VCAM-1表达均大于HOMA-IR<2.2组孕妇(均P<0.05)。GDM孕妇血清及胎盘TNF-α、VCAM-1表达与HOMA-IR均存在正相关关系(P<0.05)。结论:GDM孕妇TNF-α与VCAM-1异常升高,并与胰岛素抵抗有关。Objective:To analyze the expression of tumor necrosis factor-α(TNF-α)and vascular cell adhesion molecule(VCAM-1)in serum and placenta of women with gestational diabetes mellitus(GDM),and to explore the relationship between TNF-αand VCAM-1 levels and the insulin resistance.Methods:168 pregnant women with GDM were selected in study group and 200 normal pregnant women were selected in control group from January 2017 to June 2019.In the study group,according to area under curve(AUC)of time-glucose in OGTT and HOMA-IR,the women were further divided into 87 women in group A1(women with AUC<15.7)and 81 women in group A2(women with AUC≥15.7),and 90 women in group B1(women with HOMA-IR<2.2)and 78 women in group B2(women with and HOMA-IR≥2.2).The expressions of the TNF-αand VCAM-1 in serum and placental tissues of these women were detected by ELISA and immunohistochemistry.Results:The TNF-αlevel in serum and placental tissue(2.97±0.76 ng/ml and 0.17±0.04 OD)and the VCAM-1 level in serum and placental tissue(129.22±27.45 ng/ml and 0.15±0.06 OD)of women in the study group were significant higher than those of women in the control group,and the HOMA-IR value(2.15±0.66)of women in the study group was also significant higher than that(1.53±0.59)of women in the control group(P<0.001).In the study group,the levels of TNF-αand VCAM-1 in serum and placenta,and the HOMA-IR value of women in group A2 were significant higher than those of women in group A1(all P<0.05).In the study group,the levels of TNF-and VCAM-1 in serum and placenta of women in group B2 were significant higher than those of women in group B1(all P<0.05).The levels of TNF-αand VCAM-1 in serum and placenta of pregnant women with GDM were positively correlated with their HOMA-IR value(P<0.05).Conclusion:The levels of TNF-αand VCAM-1 of pregnant women with GDM elevate abnormally,which are associated with their insulin resistance.

关 键 词：妊娠期糖尿病 肿瘤坏死因子 血管细胞黏附分子 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学]