妊娠期糖尿病母婴血清及胎盘内脂素变化及其与胎儿生长发育的相关性研究

摘要

Objective:To study the visfatin levels in gestational diabetes maternal patient’s serum,and cord blood, also the expression of visfatin gene of placenta and adipose tissue with respect to the health of fetal. Method:The visfatin level in maternal serum and umbilical cord blood were determined by ELISA method for 40 cases of gestational diabetes and 55 cases of normal pregnant women. The expression of placenta and adipose tissue visfatin mRNA were studied by real-time fluorescence quantitative polymerase chain reaction(Real-time PCR). Result:(1)The BMI,pregnancy weight gain and neonatal birth weight of the GDM group were higher than the control group,the differences were statistically significant (P<0.05).(2)Serum visfatin level of the GDM group was significantly higher than that in the control group,the difference was statistically significant(P<0.05);neonatal umbilical cord blood serum visfatin level of the GDM group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).(3)The expression of placental tissue visfatin mRNA in the two groups was significantly different,double delta Ct method for relative quantitative analysis, expression amount of visfatin mRNA in the GDM group was 7.826 times higher than that of the control group. Expression of omental adipose tissue visfatin mRNA of two groups had no significant difference(P>0.05). Conclusion:The increase of visfatin level in serum and umbilical cord may result from the pathogenesis of GDM and the regulation of fetal growth. The change in circulating visfatin level is mainly because the placenta visfatin gene expression.%目的：探讨妊娠期糖尿病（GDM）母婴血清内脂素水平、胎盘及网膜脂肪组织内脂素基因表达及其与胎儿生长发育的关系。方法：采用双抗体夹心酶联免疫吸附法测定40例妊娠期糖尿病及55例正常孕妇母血清及新生儿脐血血清中内脂素水平；采用实时荧光定量聚合酶链反应（Real-time PCR）检测两组胎盘及网膜脂肪组织内脂素mRNA的表达。结果：（1）GDM组孕妇产前BMI、孕期体重增长、新生儿出生体重高于对照组，差异有统计学意义（P<0.05）；（2）GDM组孕妇血清内脂素水平显著高于对照组，差异有统计学意义（P<0.05）；GDM组新生儿脐血血清内脂素水平显著高于对照组，差异有统计学意义（P<0.05）；组内比较，两组脐血内脂素水平均显著高于母血内脂素水平，差异有统计学意义（P<0.05）；（3）两组胎盘组织内脂素mRNA表达有显著差异，双△Ct法进行相对定量分析，GDM组内脂素mRNA表达量是对照组的7.826倍；两组网膜脂肪组织内脂素mRNA表达比较差异无统计学意义（P>0.05）。结论：GDM孕妇血清及脐血内脂素水平的升高可能参与了GDM的发生发展以及胎儿宫内发育的调节，循环中内脂素的变化主要来自于胎盘内脂素基因表达的变化。