妊娠糖尿病患者血清、脐血及胎盘组织中Visfatin和Chemerin的表达与胰岛素抵抗发生机制的研究  

Expression of Visfatin and Chemerin in Serum,Umbilical Blood and Placenta of Patients with Gestational Diabetes Mellitus and the Mechanism of Insulin Resistance

作　　者：王伟[1] 张静[1] 浦春[2] WANG Wei;ZHANG Jing;PU Chun(Department of Laboratory Medicine,Fuyang People’s Hospital,Anhui Fuyang 236004,China;Wannan Medical College,Anhui Wuhu 241000,China)

机构地区：[1]阜阳市人民医院检验科,安徽阜阳236004 [2]皖南医学院,安徽芜湖241000

出　　处：《现代检验医学杂志》2022年第1期21-27,共7页Journal of Modern Laboratory Medicine

基　　金：安徽省自然科学基金项目(2008085QH422)。

摘　　要：目的探讨妊娠糖尿病(gestational diabetes mellitus,GDM)患者血清、脐血及胎盘组织中的内脏脂肪组织(Visfatin)、脂肪因子趋化素(Chemerin)的表达变化及与患者发生胰岛素抵抗的关系。方法选取阜阳市人民医院2018年12月~2020年4月妊娠分娩的GDM孕妇100例作为GDM组、糖耐量正常孕妇100例作为NGT组。统计分析两组的一般资料、血糖指标、血脂指标,检测两组研究对象血清、脐血、胎盘组织中的Visfatin,Chemerin表达水平,分析Visfatin,Chemerin表达与胰岛素抵抗指数(HOMA-IR)的相关性;通过重组慢病毒载体构建Visfatin,Chemerin过表达的3T3-L1脂肪细胞,分析Visfatin,Chemerin过表达对3T3-L1脂肪细胞增殖、葡萄糖消耗量、Akt及pAkt蛋白表达的影响。结果GDM组的FPG(5.84±0.52mmol/L),Fins(18.96±3.75μU/ml),HbA1c(6.42%±0.89%),HOMA-IR(2.48±0.66),TC(5.22±0.57mmol/L)和TG(2.41±0.43mmol/L)测定值均高于NGT组(4.61±0.40mmol/L,12.53±2.20μU/ml,5.31%±0.70%,1.51±0.42,4.86±0.49mmol/L和2.18±0.34mmol/L),差异具有统计学意义(t=18.749,14.789,9.803,12.399,4.789,4.196,均P<0.05);GDM组和NGT组的HDL-C(1.64±0.22mmol/L vs 1.70±0.24mmol/L),LDL-C(3.23±0.67 mmol/L vs 3.10±0.54 mmol/L)和ALB(37.84±3.02g/L vs 38.44±3.30 g/L)测定值比较,差异均无统计学意义(t=-1.843,1.511,-1.341,均P>0.05);GDM组的血清、脐血、胎盘组织中的Visfatin(10.55±2.41pg/ml,9.87±2.26 pg/ml,0.421±0.093/βactin)和Chemerin(233.0±47.6 ng/ml,438.1±95.0 ng/ml,1.338±0.207/βactin)测定值均高于NGT组(6.39±1.05pg/ml,6.11±0.94pg/ml,0.235±0.074/βactin;155.7±30.6ng/ml,218.7±76.8ng/ml,0.905±0.152/βactin),差异具有统计学意义(t=13.660~17.960,均P<0.05);GDM组的血清、脐血和胎盘组织中的Visfatin和Chemerin水平与HOMA-IR测定值均呈显著的正相关关系(r=0.357~0.583,均P<0.05);在细胞实验中,Chemerin过表达组与Visfatin过表达组的3T3-L1脂肪细胞葡萄糖消耗量均低于Chemerin空载组、Visfatin空载组(t=-12.175,5.319,均P<Objective To explore the expression changes of visceral adipose tissue(Visfatin)and adipokines(Chemerin)in serum,cord blood and placental tissue of patients with gestational diabetes mellitus mellitus(GDM)and their relationship with insulin resistance.Methods 100 pregnant women with GDM in Fuyang People’s Hospital from December 2018 to April 2020 were selected as GDM group and 100 pregnant women with normal glucose tolerance(NGT group).The general data,blood glucose indexes,and blood lipid indexes of the two groups were statistically analyzed.Detected the expression levels of Visfatin and Chemerin in the serum,cord blood,and placental tissues of the two groups of study subjects,and analyzed the correlation between Visfatin and Chemerin expression and insulin resistance index(HOMA-IR).Constructed Visfatin by recombinant lentiviral vector,Chemerin overexpression 3T3-L1 adipocytes,and analyzed the effect of Visfatin and Chemerin overexpression on 3T3-L1 adipocyte proliferation,glucose consumption,Akt and pAkt protein expression.Results The measured values of GDM group FPG(5.84±0.52mmol/L),Fins(18.96±3.75μU/ml),HbA1c(6.42%±0.89%),HOMA-IR(2.48±0.66),TC(5.22±0.57mmol/L),TG(2.41±0.43mmol/L)were higher than those of NGT group(4.61±0.40mmol/L,12.53±2.20μU/ml,5.31%±0.70%,1.51±0.42,4.86±0.49mmol/L和2.18±0.34mmol/L),the differences were statistically significant(t=18.749,14.789,9.803,12.399,4.789,4.196,all P<0.05).There was no statistically significant difference between the measured values of HDL-C(1.64±0.22mmol/L vs 1.70±0.24mmol/L),LDL-C(3.23±0.67 mmol/L vs 3.10±0.54 mmol/L)and ALB(37.84±3.02g/L vs 38.44±3.30 g/L)in the GDM group and the NGT group(t=-1.843,1.511,-1.341,all P>0.05).The Visfatin(10.55±2.41pg/ml,9.87±2.26 pg/ml,0.421±0.093/βactin)and Chemerin(233.0±47.6 ng/ml,438.1±95.0 ng/ml,1.338±0.207/βactin)measured values in serum,cord blood,and placenta tissue of the GDM group were higher than those of the NGT group(6.39±1.05pg/ml,6.11±0.94pg/ml,0.235±0.074/βactin;155.7±30.6ng/ml,218

关 键 词：妊娠糖尿病 内脏脂肪组织 脂肪因子趋化素 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学] R392.11[医药卫生—临床医学]