妊娠期糖尿病母儿血清瘦素水平和胎盘瘦素表达及其与胰岛素的关系

目的 :探讨妊娠期糖尿病母儿瘦素水平变化和胎盘瘦素mRNA表达 ,以及与胰岛素的关系。方法 :1999年 10月至 2 0 0 2年 2月 ,采用放射免疫法检测 18例妊娠期糖尿病孕妇 (观察组 )、2 0例正常孕妇 (对照组 )母儿血胰岛素和瘦素水平。采用逆转录聚合酶链反应 (RT PCR)和荧光定量分析法检测胎盘瘦素mRNA表达水平。结果 :观察组母血胰岛素、母血瘦素、脐血胰岛素、脐血瘦素和胎盘组织mRNA表达水平高于对照组 (P <0 .0 5 ) ,观察组母血瘦素与母血胰岛素水平与新生儿体重正相关 (r =0 .5 0 ,0 .4 8;P <0 .0 5 ) ,脐血瘦素和胰岛素水平与胎盘瘦素mRNA表达水平正相关 (r =0 .5 1,0 .5 3;P <0 .0 5 )。结论 :妊娠期糖尿病母儿同时存在高瘦素血症和高胰岛素血症 ,高胰岛素血症上调胎盘组织瘦素mRNA的表达 ,与巨大儿发生有关。

Maternal and neonatal serum leptin levels and expression of placental leptin mRNA and their relationship to insulin concentrations in gestational diabetes mellitus

Objective: To investigate the changes in expression of placental leptin mRNA and serum leptin concentrations, and association with insulin levels in gestational diabetes mellitus (GDM). Methods: Placental tissues and maternal and neonatal blood samples were collected from 18 gestational diabetes mellitus and 20 healthy pregnant women between Oct. 1999 and Feb. 2002. Serum leptin and plasma insulin concentration were detected by radioimmunoassay (RIA). The expression of leptin mRNA in placenta were quantitated by using RT-PCR and EB-fluorescence intensity analysis. Results: In GDM group, maternal and and also the expression levels of placental leptin mRNA (P<0.05). Maternal and neonatal serum leptin levels positively correlated with maternal and neonatal plasma insulin levels, respectively (r=0.53, r=0.46, P<0.05) in GDM group. The significant correlations were observed between neonatal birth weight and leptin(r=0.50, P<0.05), insulin (r=0.48, P<0.05) concentrations in umbilical blood. Umbilical serum leptin and plasma insulin levels were strongly related to placental leptin mRNA expression(r=0.51, 0.53;P<0.05). Conclusions:In GDM, both mothers and fetus have hyperleptinemia and hyperinsulinemia that may play a role as a regulator for fetal growth. There is an up-regulate action of hyperinsulinemia for placental leptin mRNA expression of GDM that may be one of the reasons of macrosomic infant in GDM.