妊娠糖尿病患者Th17/Treg细胞相关因子的检测及临床意义

目的 检测妊娠糖尿病(GDM)患者外周血Th17/Treg细胞相关因子的表达水平,探讨Th17/Treg在GDM炎症机制中的作用.方法 选取GDM患者(GDM组)45例,妊娠糖耐量正常者(非GDM组)40例,健康对照者(NGT组)50例,采用ELISA法分别检测Th17细胞相关因子IL-17、IL-6、IL-1β及Treg细胞相关因子TGF-β、IL-10的表达水平,并分析上述细胞因子与GDM患者空腹血糖(FBG)、餐后血糖(PBG)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)的相关性.结果 与NGT组比较,非GDM组、GDM组IL-17、IL-6、IL-1β水平明显上升,差异有统计学意义(P<0.05),且GDM组较非GDM组上升更明显(P<0.05); GDM组TGF-β、IL-10水平明显低于NGT组和非GDM组,差异有统计学意义(P<0.05),而后两组间无明显差异(P>0.05);相关性分析显示,CRP与IL-17、IL-1β均呈正相关,与TGF-β呈负相关.结论 GDM患者中存在Th17细胞相关因子的高表达和Treg细胞相关因子的表达下调,提示Th17/Treg可能以炎症与抗炎症失衡的方式参与GDM的炎症发病机制.

Detection and significance of cytokines of Th17 and Treg cells in gestational diabetes mellitus patients

Objective To detect the expression levels of cytokines associated with Th17 and Treg cells in patients with gestational diabetes mellitus(GDM) and to explore the function of these cells in the inflammation pathological mechanism of GDM.Methods 45 cases of women with GDM(GDM group),40 healthy gestational women(no-GDM group) and 50 healthy women(NGT group) were enrolled and divided into 3 groups according to ADA diagnostic standard.Plasma levels of IL-17,IL-6 and IL-1β associated with Th17 cells,and the levels of TGF-β and IL-10 associated with Treg cells were detected by ELISA.Correlation of all these cytokines and fasting blood glucose(FBG),postprandial plasma glucose(PBG),glycated hemoglobin A1c(HbA1c),C-reactive protein(CRP) were analyzed by Pearson linear correlation.Results Compared with NGT group,levels of IL-17,IL-6 and IL-1β in no-GDM and GDM group were significantly higher(P<0.05),while they were higher in GDM group than in no-GDM group.Expression levels of TGF-β and IL-10 were significantly lower in GDM group than both of NGT group and no-GDM group,but with no obvious difference between the two groups after(P>0.05).Correlation analysis showed that CRP was positively correlated with IL-17 and IL-1β,but negatively correlated with TGF-β.Conclusion The higher expression of Th17 cytokines and the lower expression of Treg cytokines could indicate that Th17/Treg might be involved in the pathogenesis of GDM by inflammation and anti-inflammatory imbalances mechanism.