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目的:研究妊娠妇女骨骼肌中葡萄糖转运蛋白4(glucose transporter 4,GLUT4)、磷酸化-一磷酸腺苷激活的蛋白激酶(Pro-AMP activated protein kinase,Pro-AMPK)的表达及其与妊娠期胰岛素抵抗的可能关系。方法:用超高速离心法分离骨骼肌细胞膜。用免疫印记(Western blot)检测15例正常妊娠妇女(产妇组)和13例正常未孕妇女(对照组)骨骼肌Pro-AMPK、细胞膜GLUT4蛋白的表达,同时检测体重指数(BMI)、血脂水平和胰岛素抵抗指数(HOMA-IR)。结果:(1)产妇组HOMA-IR的水平明显高于对照组(P=0.002);血清总胆固醇(TC)、甘油三酯(TG)水平差异有统计学意义(P<0.05),而高密度脂蛋白(HDL)、低密度脂蛋白(LDL)水平差异无统计学意义(P>0.05),但都在正常范围内。(2)产妇组骨骼肌AMPK磷酸化水平与细胞膜GLUT4蛋白表达均明显低于对照组,差异有统计学意义(P<0.0001)。(3)产妇组骨骼肌AMPK磷酸化程度及细胞膜GLUT4蛋白表达水平分别与HOMA-IR呈负相关(r=-0.547,-0.540;P=0.0347,0.0379)。GLUT4蛋白表达水平与AMPK磷酸化程度无相关性(r=0.243;P=0.3824)。结论:妊娠可能抑制葡萄糖利用的AMPK信号通路,降低AMPK活性及GLUT4细胞膜转位从而参与妊娠期胰岛素抵抗的发生。
Objective: To study the expression of glucose transporter 4 (GLUT4) and Pro-AMPK in skeletal muscle of pregnant women and its correlation with gestational age The possible relationship between insulin resistance. Methods: Skeletal muscle cell membranes were isolated by ultra-high speed centrifugation. The protein expression of Pro-AMPK and GLUT4 in skeletal muscle of 15 normal pregnant women (maternal group) and 13 normal pregnant women (control group) was detected by Western blot. Meanwhile, body mass index (BMI), blood lipid level And insulin resistance index (HOMA-IR). Results: (1) The level of HOMA-IR in the maternal group was significantly higher than that in the control group (P = 0.002). The levels of total cholesterol (TC) and triglyceride (TG) There was no significant difference in HDL and LDL between the two groups (P> 0.05), but both were within the normal range. (2) AMPK phosphorylation and GLUT4 protein expression in skeletal muscle of maternal group were significantly lower than those in control group, the difference was statistically significant (P <0.0001). (3) AMPK phosphorylation and GLUT4 protein expression in skeletal muscle of maternal group were negatively correlated with HOMA-IR (r = -0.547, -0.540; P = 0.0347,0.0379). There was no correlation between GLUT4 protein expression and AMPK phosphorylation (r = 0.243; P = 0.3824). Conclusion: Pregnancy may inhibit AMPK signaling pathway of glucose utilization, reduce AMPK activity and GLUT4 cell membrane translocation and thus participate in the occurrence of insulin resistance during pregnancy.