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目的研究内脏脂肪素(Visfatin)在GDM患者血清、胎盘组织及脐血中的表达及其在GDM发生中的作用及与新生儿结局的相关性。方法选取于我院妇产科行剖宫产术终止妊娠的GDM组37例,另选糖耐量正常妊娠组(GNGT)35名,分别测定两组FPG、FIns、HbA_1c、TC、TG、LDL-C、HDL-C;稳态模型评估胰岛素抵抗指数(HOMA-IR);测量婴儿出生体重和身高,计算Ponderral(PI)指数及孕妇BMI。ELISA测定两组母体血清、脐血Visfatin水平;Western blot测定胎盘组织Visfatin蛋白表达。结果 GDM组分娩前血清FPG、FIns、HbA_1c、TC、TG、LDL-C及HOMA-IR均高于GNGT组,HDL-C低于GNGT组(P<0.05)。GDM组新生儿PI指数及胎盘组织Visfatin蛋白水平表达与GNGT组比较,差异有统计学意义(P<0.05);GDM组母体静脉血、新生儿脐血Visfatin水平高于GNGT组(P<0.05)。相关分析结果显示,血清Visfatin水平与HOMA-IR、FIns、FPG呈正相关(P<0.05)。结论GDM患者血清、胎盘及其新生儿脐血Visfatin水平的升高可能参与了GDM的发生发展,以及胎儿宫内发育的调节。
Objective To study the expression of Visfatin in serum, placenta and cord blood of patients with GDM and its role in the development of GDM and its relationship with neonatal outcome. Methods 37 cases of GDM group and 35 cases of normal glucose tolerance group (GNGT) were enrolled in the obstetrics and gynecology department of our hospital. The levels of FPG, FIns, HbA 1c, TC, TG, LDL- C, HDL-C; homeostasis model assessment of insulin resistance index (HOMA-IR); measurement of infant birth weight and height, calculation of Ponderral (PI) index and pregnant women BMI. Visfatin levels of maternal serum and umbilical cord blood were measured by ELISA. The expression of Visfatin protein in placenta was detected by Western blot. Results The serum levels of FPG, FIns, HbA1c, TC, TG, LDL-C and HOMA-IR of GDM group before delivery were higher than those of GNGT group and HDL-C group was lower than that of GNGT group (P <0.05). GDM group, neonatal PI index and placental Visfatin protein expression levels compared with GNGT group, the difference was statistically significant (P <0.05); GDM group of maternal venous blood, neonatal cord blood Visfatin levels were higher than GNGT group (P <0.05) . Correlation analysis showed that serum Visfatin level was positively correlated with HOMA-IR, FIns and FPG (P <0.05). Conclusion The elevated levels of Visfatin in serum, placenta and umbilical cord blood of GDM patients may be involved in the development of GDM and the regulation of intrauterine growth.