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目的 探讨妊娠期糖尿病 (gestationaldiabetesmellitus ,GDM)母儿血清瘦素水平及胎盘瘦素表达的变化。 方法 采用放射免疫法 (RIA)检测 2 4例GDM母儿和 2 6例正常母儿血清胰岛素和瘦素水平 ,采用逆转录 聚合酶链反应 (RT PCR)技术检测胎盘瘦素mRNA的表达水平。 结果 (1)GDM组孕妇血清瘦素和胰岛素水平分别为 (18.6 2± 7.86 ) μg/L和 (13.4 7± 5 .11)mIU/L ,对照组分别为 (14 .2 1± 7.5 9) μg/L和 (8.98± 4 .2 3)mIU/L ,两组比较差异有显著性 (P <0 .0 5 )。 (2 )GDM组脐血瘦素和胰岛素水平分别为 (17.93± 6 .14 ) μg/L和 (19.2 6± 6 .73)mIU/L ,对照组分别为 (7.2 7± 4 .32 ) μg/L和 (9.6 7± 4 .89)mIU/L ,两组比较差异有显著性 (P <0 .0 1)。 (3)两组孕妇血清瘦素与胰岛素水平之间无相关关系 (r =0 .2 2 ,P >0 .0 5 ) ,而脐血血清瘦素与胰岛素水平之间呈正相关关系(r =0 .5 3,P <0 .0 1)。 (4 )GDM组胎盘瘦素mRNA表达水平为 (1.92± 0 .0 5 ) ,对照组为 (0 .97± 0 .0 2 ) ,两组比较差异有显著性 (P <0 .0 1)。 结论 胰岛素及瘦素抵抗可能是妊娠期糖尿病的发病原因之一 ,胰岛素对调节胎盘瘦素的表达起重要作用。
Objective To investigate the changes of maternal and fetal serum leptin level and placental leptin expression in gestational diabetes mellitus (GDM). Methods The levels of serum insulin and leptin were detected by radioimmunoassay (RIA) in 24 cases of GDM and 26 cases of normal maternal. The expression of placental leptin mRNA was detected by reverse transcriptase-polymerase chain reaction (RT-PCR). Results (1) The levels of serum leptin and insulin in pregnant women with GDM were (18.62 ± 7.86) μg / L and (13.47 ± 5.11) mIU / L, respectively, and those in the control group were (14.21 ± 7.59) μg / L and (8.98 ± 4.23) mIU / L, the difference between the two groups was significant (P <0.05). (2) Leptin and insulin levels in cord blood of GDM group were (17.93 ± 6.14) μg / L and (19.2 6 ± 6.73) mIU / L, respectively, and those in control group were (7.2 7 ± 4.32) μg / L and (9.67 ± 4.89) mIU / L, the difference between the two groups was significant (P <0.01). (3) There was no correlation between serum leptin level and insulin level in the two groups (r = 0.22, P> 0.05), but there was a positive correlation between serum leptin level and insulin level (r = 0 .5 3, P <0 .0 1). (4) The level of placental leptin mRNA in GDM group was (1.92 ± 0.55) and in control group (0.97 ± 0.22), there was significant difference between the two groups (P <0.01) . Conclusion Insulin and leptin resistance may be one of the causes of gestational diabetes mellitus. Insulin plays an important role in regulating the expression of placental leptin.