妊娠期糖尿病孕妇孕期SFRP5表达与胰岛素抵抗的关系

摘要

目的 探讨妊娠期糖尿病(GDM)孕妇孕期分泌型卷曲相关蛋白5(SFRP5)的表达与胰岛素抵抗的关系.方法 筛选2016年1月～2017年3月在内蒙古自治区妇幼保健院产检的50名正常孕妇作为对照组,50例确诊为GDM的孕妇为实验组.比较两组孕24～28周空腹胰岛素、空腹血糖、血脂检查结果;采用酶联免疫吸附法对两组产妇剖宫产分娩时的肘静脉血清中的SFRP5表达水平进行检测;③分别取对照组及实验组各30例孕妇皮下脂肪,采取RT-PCR方法检测人脂肪细胞中SFRP5 mRNA的表达水平.结果 两组孕妇血清与脂肪中均有SFRP5表达,实验组的血清及脂肪中的SFRP5表达水平显著低于对照组(P＜0.01);血清SFRP5的表达与HOMA-IR、胆固醇、三酰甘油、低密度脂蛋白胆固醇呈负相关(r=-0.5706、-0.1479、-0.1541、-0.1366,均P＜0.05),与高密度脂蛋白胆固醇呈正相关(r=0.0866,P＜ 0.01).结论 SFRP5的异常表达与GDM的发生发展有关,通过临床监测SFRP5的表达情况能早期发现胰岛素抵抗的发生,降低GDM发病率.因此,孕期对孕妇进行良好的营养指导,严格体重管理,可以减少胰岛素抵抗,改善GDM结局.%Objective To discuss the relationship between the expression of SFRP5 and insulin resistance of pregnant women with gestational diabetes mellitus (GDM).Methods Fifty cases of normal pregnant women in Maternal and Child Health Hospital of Inner Mongolia from January 2016 to March 2017 were selected as control group,and 50 cases with GDM were selected as experimental group.The level of fasting insulin,fasting blood glucose and blood lipid from 24 to 28 weeks of pregnancy was compared between the two groups.Enzyme-linked immunosorbent method was used to test the expression of SFRP5 in cubital vein serum of the puerperas in the two groups during cesarean section.Subcutaneous adipose of 30 cases between the two groups was taken respectively,and the expression of SFRP5 mRNA was tested by RT-PCR.Results SFRP5 was expressed in serum and adipose of the experimental group and the control group.The expression of SFRP5 in serum and adipose of the experimental group was lower than that in control group significantly (P ＜ 0.01).The serum SFRP5 was negatively correlated with HOMA-IR,cholesterol,triglyceride,LDL-C (r =-0.5706,-0.1479,-0.1541,-0.1366,all P ＜ 0.05),the serum SFRP5 and high density lipoprotein have the positive correlation relationship (r =0.0866,P ＜ 0.01).Conclusion The abnormal expression of SFRP5 is related to the occurrence and development of GDM.Through clinical monitoring the expression of SFRP5,the occurrence of insulin resistance can be discovered early,and reduce the morbidity of GDM.During pregnancy,offer good nutrition guidance and strict weight-control to pregnant women can reduce the occurrence of insulin resistance,and improve the pregnancy success rate in GDM.