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目的探讨胎盘上瘦素和脂联素基因表达与妊娠期糖尿病(GDM)的关系,以及瘦素和脂联素表达对孕妇和胎儿的影响。方法选取2009年1月至2010年3月本院分娩的GDM孕妇及其新生儿各40例为GDM组,同期分娩糖耐量正常的孕妇及其新生儿各40例为对照组,分娩时留取两组孕妇的胎盘组织,通过反转录聚合酶链反应法分别测定胎盘组织中瘦素及脂联素mRNA表达量,新生儿出生2h内测量体重、身长、头围、上臂围及GDM组新生儿的血糖值。比较两组孕妇胎盘中瘦素及脂联素mRNA表达水平,对GDM组瘦素和脂联素mRNA表达量与新生儿体质指标进行相关分析。结果 GDM组胎盘中瘦素表达量高于对照组,脂联素低于对照组[(0.097±0.051)比(0.065±0.033),(0.054±0.029)比(0.082±0.043),P均<0.05],血糖控制欠佳的GDM孕妇差别更明显。胎盘组织中脂联素mRNA表达量与新生儿体重、头围负相关(r分别为-0.425和-0.367,P<0.05)。结论 GDM时胎盘中瘦素和脂联素表达水平的改变可能与GDM发病存在关联,且胎盘脂联素水平的改变可能对宫内胎儿的生长发育产生影响。
Objective To investigate the relationship between the placental leptin and adiponectin gene expression and gestational diabetes mellitus (GDM), and the effects of leptin and adiponectin on pregnant women and fetus. Methods From January 2009 to March 2010, 40 pregnant women with GDM and 40 newborns in our hospital were selected as GDM group. Forty pregnant women with normal glucose tolerance and their newborns during the same period were selected as control group. Two groups of pregnant women placenta tissue, respectively, by reverse transcription-polymerase chain reaction were measured placental tissue leptin and adiponectin mRNA expression, birth within 2h weight, body length, head circumference, upper arm circumference and GDM group of newborn Children’s blood glucose value. The levels of leptin and adiponectin in the placenta of two groups were compared, and the correlation between leptin and adiponectin mRNA expression levels and neonatal physical fitness was analyzed. Results The placental expression of leptin in GDM group was higher than that in control group (0.097 ± 0.051, 0.065 ± 0.033, 0.082 ± 0.043, P <0.05, respectively) ], GDM pregnant women with poor glycemic control are more pronounced. Adiponectin mRNA expression in placenta was negatively correlated with body weight and head circumference (r = -0.425 and -0.367, P <0.05, respectively). Conclusion The changes of leptin and adiponectin in placenta of GDM may be related to the pathogenesis of GDM, and the change of placental adiponectin level may have an impact on the growth and development of intrauterine fetus.