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目的探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与妊娠期糖尿病(GDM)孕妇胰岛素抵抗的关系。方法选择2011年9月至2013年2月于我院妇产科门诊行产前检查并于我院行剖宫产的GDM患者28例,正常对照组21例。测定所有研究对象皮下脂肪组织中NGALmRNA及其蛋白,血清NGAL、空腹血糖、空腹胰岛素及TNF-α水平,计算体重指数(BMI),应用稳态模型胰岛素抵抗指数(HOMA-IR)作为评价胰岛素敏感性的指标。正态性数据组间比较采用独立样本t检验,相关性分析采用Spearman分析,非正太数据采用秩转换的非参数检验。结果 GDM组孕妇血清NGAL、TNF-α水平以及HOMA-IR指数明显高于对照组(P<0.05);GDM组孕妇皮下脂肪组织中NGAL mRNA及其蛋白水平(0.930.33,5.461.35)较对照组(0.520.28,3.381.29)明显升高(P<0.001);GDM组孕妇脂肪组织中NGAL mRNA与TNF-α、HOMA-IR指数均呈明显正相关(r=0.641,0.537;P<0.05);NGAL蛋白与TNF-α、HOMA-IR指数均呈明显正相关(r=0.583,0.496;P<0.05)。结论 GDM孕妇皮下脂肪组织和血清NGAL水平较对照组显著升高,提示NGAL可能通过影响胰岛素抵抗,参与GDM的发生。
Objective To investigate the relationship between neutrophil gelatinase-associated lipocalin (NGAL) and insulin resistance in pregnant women with gestational diabetes mellitus (GDM). Methods From September 2011 to February 2013 in our hospital obstetrics and gynecology clinic prenatal examination and cesarean section in our hospital 28 cases of GDM patients, 21 cases of normal control group. The levels of NGAL mRNA, protein, serum NGAL, fasting blood glucose, fasting insulin and TNF-α in subcutaneous adipose tissue of all the subjects were measured to calculate the body mass index (BMI), and the homeostasis model insulin resistance index (HOMA-IR) Sexual indicators. Normality data were compared using independent samples t-test, correlation analysis using Spearman analysis, non-normal data using the non-parametric test of rank conversion. Results The serum levels of NGAL, TNF-α and HOMA-IR in GDM group were significantly higher than those in control group (P <0.05). NGAL mRNA and protein levels in subcutaneous adipose tissue of GDM group (0.930.33, 5.461.35) The levels of NGAL mRNA and TNF-α and HOMA-IR in adipose tissue of pregnant women in GDM group were significantly positively correlated (r = 0.641, 0.537; P <0.05). There was a significant positive correlation between NGAL protein and TNF-α and HOMA-IR index (r = 0.583,0.496; P <0.05). Conclusion The levels of subcutaneous adipose tissue and serum NGAL in GDM pregnant women were significantly higher than those in control group, suggesting that NGAL may be involved in the development of GDM by affecting insulin resistance.