脂肪细胞型脂肪酸结合蛋白与妊娠期糖尿病的相关性研究

摘要

研究脂肪细胞型脂肪酸结合蛋白(FABP4)与妊娠期糖尿病(GDM)及胰岛素抵抗(IR)的相关性.方法:选取孕妇60例,分为GDM正常组、GDM超重组和正常妊娠妇女(NGT)组,每组20例.采用酶联免疫吸附试验和免疫组化方法检测3组患者血清和胎盘组织中FABP4的表达,检测空腹血糖(FBG)、血清胰岛素(FINS)、三酰甘油和总胆固醇水平；采用稳态模型计算胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI)及胰岛β细胞功能(HOMA-B％),比较3组的相关资料.结果:GDM正常组的孕前BMI、三酰甘油、FBG、FINS、HOMA-IR及HOMA-ISI与GDM超重组比较差异有统计学意义(P＜0.01).GDM正常组的三酰甘油、总胆固醇、FBG、HOMA-IR、HOMA-B％及HOMA-ISI和NGT组比较差异均有统计学意义(P＜0.01)；3组血清(Welch=9.663)和胎盘组织(Hc=17.278)中FABP4浓度差别有统计学意义(均P＜0.01).胎盘组织中FABP4比较,GDM正常组高于NGT组(Z=3.147,P=0.002),GDM正常组和GDM超重组差异无统计学意义(Z=1.007,P=0.314).结论:脂肪细胞因子FABP4在GDM发生过程中起重要作用.%Objective:To study the relationship between the expression of adipocyte fatty-acid binding protein (FABP4) in placental tissues and the insulin resistance (IR) in patients with gestational diabetes nielli tus (GI)M). Methods: Sixty pregnant women were divided into three groups including GDM group, GDM with overweight (NGT) group and normal control group (n=20 for each group). The expressions of FABP4 in serum and placental tissues were detected by enzyme-linked im-munosorbent assay (EL1SA) and immunohistochemisty in patients of three groups. The levels of fasting blood glucose (FBG), insulin levels (FINS), triglyceride and total cholesterol were detected in patients as well. The values of IR, the index of insulin resistance (ISI) and β-cell function (B%) were calculated using homeostasis model (HOMA) and compared between three pro-gestation patient groups. Results: There were significant differences in the body mass index (BMI), triglyceride, FBG, FINS, HOMA-IR and HOMA-ISI between GDM and GDM with overweight group (P < 0.01). There were significant differences in triglyceride, total cholesterol, FBG, HOMA-IR, HOMA-B% and HOMA-ISI between GMD group and control group (P < 0.01). The levels of FABP4 were different in serum (Welch = 9.663) and placental tissues (Hc = 17.278) in three groups (P < 0.01). The level of FABP4 was higher in placental tissues of GMD group than that of NGT group (Z = 3.147,P = 0.002),but no significant difference was found between GDM and NGT groups (Z = 1.007, P = 0.314). Conclusion: The adipoeytokine-FABP4 may play an important role in the process of GDM.