葛根素联合门冬胰岛素对妊娠期糖尿病患者 TLR4／NF－κB 炎症信号通路及脂肪因子的影响

摘要

Objective To observe the effects of puerarin combined with insulin aspart on plasma monocyte Toll-like receptors 4uclear factor kappa B ( TLR4/NF-κB ) inflammatory signal pathway and adipokine in pregnant women with gestational diabetes mellitus ( GDM ) .Methods A total of 100 patients with GDM who were admitted and treated in our hospital from June 2013 to December 2015 were randomly divided into observation group ( n =50) and control group ( n =50).The patients in control group were treated by insulin aspart ,however,the patients in observation group were treated by puerarin combined with insulin aspart .After treatment, the expression levels of TLR4, NF-κB and IκB mRNA and protein, interleukin 6 (IL-6), interleukin 12 (IL-12), tumor necrosis factor alpha (TNF-α), C reactive protein (CRP), chemerin, adiponectin ( APN) and visfatin were detected and compared between two groups .Results After the treatment , the expression levels of TLR4 and NF-κB mRNA and protein, IL-6, IL-12, TNF-α, CRP and visfatin in observation group were significantly decreased in both groups , as comapred with those before treatment , but the expression levels of IκB mRNA and protein, chemerin and APN in both groups were significantly increased , as compared with those before treatment ( P <0 .05 ) . However the improvement degree of the indexes mentioned above in observation group was superior to that in control group (P<0.05).Conclusion The puerarin combined with insulin aspart in treatment of GDM can obviously inhibit the release of inflammatory factors by regulating the activation of TLR 4/NF-κB inflammatory signal pathway and modulating the secretion of adipocytokines .%目的：观察葛根素联合门冬胰岛素对妊娠期糖尿病（ GDM）患者外周血单核细胞Toll样受体4／核因子－κB（ TLR4／NF－κB）炎症信号通路及脂肪因子的影响。方法选取2013年6月至2015年12月诊治的GDM患者100例，随机分为对照组和观察组，每组50例。对照组给予门冬胰岛素治疗，观察组在对照组基础上加用葛根素注射液治疗。比较2组外周血单核细胞（ PBMC） TLR4、NF－κB、IκB mRNA和蛋白表达及血清白细胞介素6（ IL－6）、白细胞介素12（IL－12）、肿瘤坏死因子α（TNF－α）、C－反应蛋白（CRP）、网膜素（chemerin）、脂联素（APN）、内脂素（visfatin）变化。结果2组治疗后TLR4、NF－κB mRNA和蛋白表达、IL－6、IL－12、TNF－α、CRP、visfatin水平较治疗前显著降低，IκB mR－NA和蛋白表达、chemerin、APN水平较治疗前显著升高（ P ＜0．05），但观察组以上指标改善程度优于对照组，差异有统计学意义（ P ＜0．05）。结论葛根素联合门冬胰岛素能够明显抑制TLR4／NF－κB炎症信号通路活化引起的炎性因子的释放，并调控脂肪因子分泌。