11β-HSD1和11β-HSD2在妊娠期糖尿病患者胎盘组织中的差异表达及临床意义

目的 研究妊娠糖尿病患者胎盘组织中11β-羟类固醇脱氢酶(11β-HSD1)和11β-HSD2基因和蛋白表达的变化及意义.方法 选择妊娠期糖尿病(GDM)和糖耐量正常孕妇(NGT)各30例,化学发光法测定皮质醇、胰岛素的水平,免疫组织化学法检测11β-HSD1和11β-HSD2在胎盘的表达部位,分别运用荧光定量PCR(real time PCR)和Western blot法测试11β-HSD1和11β-HSD2基因和蛋白水平的差异表达.结果 与NGT组相比,GDM组空腹胰岛素、HOMA-IR、胰岛素分泌指数、母血皮质醇水平明显增高(P<0.05),而空腹血糖、胎儿脐血皮质醇则差异无统计学意义(P>0.05).1β-HSD1和11β-HSD2均在胎盘中有表达,表达部位及水平不同.real time-PCR和Western blot检测结果提示GDM组胎盘11β-HSD1 mRNA和蛋白的表达明显低于NGT组(P<0.05),11β-HSD2 mRNA明显高于NGT组(P<0.05),而蛋白水平差异无统计学意义(P>0.05).结论 妊娠期糖尿病胎盘组织11β-HSD1和11β-HSD2差异表达调整免除母体不佳的妊娠环境将会给胎儿造成的长远伤害.

Differential expression of placental tissue 11β-HSD1 and 11β-HSD2 in patients with gestational diabetes mellitus

Objective To study the changes and significance of 11β-HSD1 and 11β-HSD2 gene and protein expression in pla-centa of patients with gestational diabetes mellitus .Methods Thirty pregnant women with gestational diabetes mellitus (GDM ) and normal glucose tolerance (NGT ) were selected .Chemiluminescence was used to determine the serum cortisol ,neonatal cord blood cortisol and fasting insulin ect .Immunohistochemistry was used to detect the expression location of 11β-HSD1 and 11β-HSD2 in the placenta .The differential expression of 11β-HSD1 and 11β-HSD2 genes and proteins were detected by real-time PCR and Western blot .Results Compared with NGT group ,fasting insulin ,HOMA-IR ,insulin secretion index and maternal serum cortisol level were significantly increased in GDM group (19 .95 ± 1 .05) mU/L vs .(12 .93 ± 1 .50) mU/L ,4 .54 ± 0 .67 vs .2 .87 ± 0 .43 , 80 .55 ± 6 .18 vs .53 .15 ± 5 .58 ,(1110 .00 ± 40 .91) nmol/L vs .(934 .1 ± 45 .92) nmol/L ,P<0 .05)] ,but there were no significant differences were found in fasting blood glucose and cord blood cortisol (P>0 .05) .The distribution of 11β-HSD1 in the placenta was distributed in the outer layer of villous syncytiotrophoblast ,villous interstitial and dry villi .The expression of 11β-HSD2 was con-centrated in the outer layer of villous syncytiotrophoblast .Real time-PCR and Western blot results showed that the expression of 11β-HSD1 mRNA and protein in placenta of GDM group was significantly lower than that of NGT group (0 .56 ± 0 .09 vs .1 .36 ± 0 .36 ,0 .27 ± 0 .07 vs .1 .00 ± 0 .01 ,P< 0 .05 ) ,11β-HSD2 mRNA was significantly higher than NGT group (5 .17 ± 1 .02 and 1 .21 ± 0 .34 respectively ,P<0 .05) ,but no significant difference was found in protein level (P>0 .05) .Conclusion The differenti-al expression of 11β-HSD1 and 11β-HSD2 in placenta of gestational diabetes mellitus can avoid the maternal poor pregnancy envi-ronment ,but will cause long-term harm to the fetus .