摘要
目的:探讨妊娠期糖尿病(GDM)胎盘组织中视黄醇结合蛋白4(RBP4)表达及其与胰岛素抵抗和分泌功能的关系。方法:收集胎盘组织共79例,其中正常组27例,GDM组52例。GDM组中未使用(GDMA_1组)和使用胰岛素治疗(GDMA_2组)者各26例。免疫组化(IHC)、Western blot、实时荧光定量PCR(qRT-PCR)检测RBP4在胎盘中的定位及其蛋白和mRNA水平表达。用稳态模式胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HBCI)分别作为胰岛素抵抗和分泌功能指标,比较3组以上指标的差异。分析RBP4表达水平与HOMA-IR和HBCI的关系。结果:RBP4表达在胎盘合体滋养细胞胞质中。GDM组的RBP4蛋白和mRNA表达均高于正常组(P<0.05)。但GDMA_1组和GDMA_2组比较差异无统计学意义(P>0.05)。从正常组到GDMA_1组再到GDMA_2组,HOMA-IR增加;GDM组高于正常组(P<0.01),但各GDM组间比较差异无统计学意义(P>0.05)。从正常组到GDMA_1组再到GDMA_2组,HBCI先升后降;GDMA_2组低于正常组、GDMA_1组(P<0.01),但后两组比较差异无统计学意义(P>0.05)。GDM组胎盘组织中RBP4蛋白表达水平与HOMA-IR呈正相关(r=0.819,P<0.01),与HBCI无相关(r=0.179,P=0.123)。正常组胎盘组织中RBP4蛋白表达水平与HOMA-IR和HBCI均不相关。结论:RBP4由胎盘分泌,通过参与胰岛素抵抗引起GDM发生,尚无明显证据显示与胰岛素的分泌功能有关。
Objective： To investigate the expression of Retinol Binding Protein 4 and its correlation with insulin resistance and insulin secretion in placenta of gestational diabetes mellitus. Methods： 79 placental tissues were collected including 27 pregnant women who had normal glucose tolerance test. There are 52 pregnant women with GDM,including 26 cases of GDMA1,and 26 cases of GDMA2. The expression of RBP4 in placenta was detected by immunohistochemistry（ IHC）,Western blot and quantitative real-time PCR（ qRT-PCR）. Insulin resistance and insulin secretion function were measured by homeostasis insulin resistance index（ HOMAIR） and homeostasis β-cell index（ HBCI） respectively. The results above were compared among the three groups. The correlation of RBP4 expression with HOMA-IR and HBCI was invested.Results： RBP4 was located on the cytoplasm of syncytiotrophoblast. The expression of RBP4 in GDM groups were higher than that in normal group. The differences between GDM groups had no statistically significant（ P〉0. 05）. From Normal group to GDMA1 group and GDMA2 group,HOMA-IR increased,which in GDM groups were higher than that in normal group（ P〈0. 01）.However,the differences between GDM groups had no statistically significant（ P〉 0. 05）. From Normal group to GDMA1 group and GDMA2 group,HBCI increased firstly and then decreased,which in GDMA_2 group were lower than that in the another two groups（ P〈0. 01）. However,the differences between Normal and GDMA_1 had no statistically significant（ P 〉0. 05）. The protein level of RBP4 in placenta of GDM group was positively correlated with HOMA-IR（ r = 0. 819,P〈0. 01）. However there was no correlation with HBCI（ r = 0. 179,P = 0. 123）. There was no correlation between the protein level of RBP4 in placenta of GDM group with HOMA-IR and HBCI. Conclusion： RBP4 is secreted by placenta,causes the occurrence of GDM by attending insulin resistance. However,there is no obvious proof display the relation between RBP4 and insulin secretion function.
出处
《现代妇产科进展》
CSCD
北大核心
2016年第10期750-753,共4页
Progress in Obstetrics and Gynecology
