妊娠期糖尿病患者脂肪细胞因子与炎症的相关性分析

目的探讨妊娠糖尿病(GDM)患者脂肪细胞因子瘦素、视黄醇结合蛋白4(RBP4)、脂联素与炎症细胞因子白介素6(IL-6)、肿瘤坏死因子α(TNF-α)的关系。方法选择GDM患者60例,正常糖耐量(NGT)孕妇44例,根据体重和身高计算晚孕期体重指数(BMI);检测空腹血糖(FBG)水平,计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI);酶法检测血清甘油三酯(TG)、总胆固醇(TC);比色法测定游离脂肪酸(FFA)水平;ELISA法检测所有孕妇血清中脂联素和RBP4水平;放射免疫法检测空腹胰岛素(FIns)、瘦素、IL-6、TNF-α水平。将两组孕妇的各指标之间进行Pearson相关分析。结果与NGT组比较,GDM组的FPG、TG、TC、FFA、瘦素、IL-6、TNF-α、RBP4水平均明显升高,脂联素水平明显下降,存在显著的炎性激活及胰岛素抵抗;HO-MA-IR、RBP4、瘦素与IL-6、TNF-α呈正相关;ISI、脂联素与IL-6、TNF-α呈负相关。结论 GDM患者由于过度分泌的脂肪细胞因子和炎性因子导致显著的炎性激活,可能是GDM中胰岛素抵抗发生发展的机制之一。

Correlation analysis of serum adipocytokines and inflammation in women with gestational diabetes mellitus

Objective To investigate the correlation between inflammatory factors IL-6,TNF-α and related adipocyte factors[adiponectin,leptin and retinol-binding protein 4(RBP4)] in gestational diabetes mellitus(GDM)patients.Methods GDM patients(GDM group,n=60) and pregnancies with normal glucose tolerance(NGT group,n=44) were enrolled,late gestational body weight was recorded,and BMI was calculated.FBG level was assayed with glucose oxidase method.ISI and HOMA-IR were calculated,serum TG,TC,ALT,AST and FFA levels were measured with enzyme methods.The concentrations of serum adiponectin and RBP4 were determined by ELISA.Serum FIns,leptin,IL-6 and TNF-α level were assayed by radioimmunoassay.The correlations between inflammatory factors and related adipocyte factors were analyzed with Pearson correlation assay.Results Compared with those in NGT group,the FPG,TG,TC,FFA,leptin,IL-6 and TNF-α were significantly increased,serum adiponectin level was significantly decreased in GDM group,which indicated significant inflammatory activation and insulin resistance;HOMA-IR,RBP4 and leptin were positively related with IL-6 and TNF-α,ISI and adiponectin were negatively related with IL-6 and TNF-α.Conclusion High expression of adipocytokines in GDM patients are positively correlated with inflammatory cytokines.It may be one of mechanism for insulin resistance in GDM patients.