妊娠期糖尿病对胎盘脂代谢的影响  

Effects of gestational diabetes mellitus on placental lipid metabolism

作　　者：辛雅萍[1] 李天天 王婉 牛茼 祝艺菡 XIN Yaping;LI Tiantian;WANG Wan;NIU Tong;ZHU Yihan(Department of Endocrinology,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014)

机构地区：[1]郑州大学第二附属医院内分泌科,郑州450014

出　　处：《郑州大学学报（医学版）》2021年第4期548-552,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关项目(201702094);河南省科技厅科技攻关项目(182102310591)。

摘　　要：目的:探讨妊娠期糖尿病(GDM)对胎盘组织脂代谢的影响及相关分子改变。方法:选择30例GDM孕妇和30例正常孕妇为研究对象,采用实时荧光定量PCR法检测胎盘组织中SNARE复合体相关基因[囊泡相关蛋白23(SNAP23)、突触融合蛋白4(STX4)、靶膜相关蛋白2(VAMP2)]及其正性调节因子Unc-18c的哺乳动物同源物(Munc18c)、脂肪酸β氧化限速酶肉碱棕榈酰转移酶1(CPT1)和促脂滴形成蛋白围脂滴蛋白2(PLIN2)mRNA表达水平,分析脂代谢相关基因表达与糖脂代谢指标的相关性。结果:GDM孕妇血TG水平和新生儿体重高于正常孕妇,其胎盘组织中脂肪含量也较正常孕妇升高(P<0.05)。GDM孕妇胎盘中SNAP23、Munc18c和CPT1 mRNA表达水平较正常孕妇降低(P<0.05)。GDM孕妇OGTT空腹血糖水平分别与SNAP23、Munc18c和CPT1 mRNA表达水平呈负相关(r=-0.549、-0.714、-0.572,P<0.05);而TG水平与Munc18c呈负相关(r=-0.788,P=0.029),与PLIN2呈正相关(r=0.577,P=0.015)。GDM组新生儿体重与Munc18c和CPT1 mRNA表达水平均呈正相关(r=0.610、0.578,P<0.05);脂代谢相关基因中,SNAP23分别与Munc18c、CPT1和PLIN2 mRNA表达水平呈正相关(r=0.514、0.672、0.579,P<0.05),而Munc18c与CPT1 mRNA表达水平呈正相关(r=0.563,P=0.035)。结论:GDM可加重母体脂代谢紊乱导致胎盘脂质蓄积,脂代谢相关基因SNAP23、Munc18c和CPT1协同参与胎盘组织脂肪酸氧化代谢下降,促进胎盘脂质蓄积。Aim:To explore the effects of gestational diabetes mellitus(GDM)on the lipid metabolism of placental tissue and related molecular changes.Methods:A total of 30 pregnant women with GDM and 30 normal pregnant women were selected.Real-time fluorescent quantitative PCR method was used to detect placental tissue SNARE complex related genes(SNAP23,STX4,VAMP2),and its positive regulator(Munc18c),fatty acidβoxidation rate-limiting enzyme(CPT1)and lipid droplet formation genes(PLIN2)mRNA.The correlation between lipid metabolism-related genes and glucose and lipid metabolism indicators was analyzed.Results:Triglyceride(TG)and birth weight of pregnant women with GDM were higher than those of normal pregnant women,and the fat content in the placental tissue was also higher than that of normal placental tissue(P<0.05).The mRNA levels of SNAP23,Munc18c and CPT1 in the placental tissue of GDM pregnant women were significantly lower than those of normal pregnant women(P<0.05).The fasting blood glucose level of GDM pregnant women was negatively correlated with the mRNA levels of SNAP23,Munc18c and CPT1(r=-0.549,-0.714,-0.572,P<0.05).TG was negatively correlated with Munc18c mRNA and positively correlated with PLIN2 mRNA(r=-0.788,0.577,P<0.05).In GDM group,the weight of newborn was positively correlated with the mRNA levels of Munc18c and CPT1(r=0.610,0.578,P<0.05);as for the lipid metabolism related genes,SNAP23 was positively correlated with the mRNA levels of Munc18c,CPT1 and PLIN2 respectively(r=0.514,0.672,0.579,P<0.05),while Munc18c was positively correlated with CPT1 mRNA level(r=0.563,P=0.035).Conclusion:GDM could aggravate maternal lipid metabolism disorder and lead to placental lipid accumulation.Lipid metabolism-related genes SNAP23,Munc18c and CPT1 are involved in the decrease of oxidative metabolism of fatty acids in placenta and placental lipid accumulation.

关 键 词：妊娠期糖尿病 胎盘 脂代谢 

分 类 号：R714.256[医药卫生—妇产科学]