[1]王　伟,张　静,浦　春.妊娠糖尿病患者血清、脐血及胎盘组织中 Visfatin和 Chemerin的表达与胰岛素抵抗发生机制的研究[J].现代检验医学杂志,2022,37(01):21-27.[doi:10.3969/j.issn.1671-7414.2022.01.005]
　WANG Wei,ZHANG Jing,PU Chun.Expression of Visfatin and Chemerin in Serum, Umbilical Blood and Placenta of Patients with Gestational Diabetes Mellitus andthe Mechanism of Insulin Resistance[J].Journal of Modern Laboratory Medicine,2022,37(01):21-27.[doi:10.3969/j.issn.1671-7414.2022.01.005]
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妊娠糖尿病患者血清、脐血及胎盘组织中 Visfatin和 Chemerin的表达与胰岛素抵抗发生机制的研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年01期
页码:
21-27
栏目:
论　著
出版日期:
2022-01-15

文章信息/Info

Title:
Expression of Visfatin and Chemerin in Serum, Umbilical Blood and Placenta of Patients with Gestational Diabetes Mellitus andthe Mechanism of Insulin Resistance
文章编号:
1671-7414（2022）01-021-07
作者:
王　伟1; 张　静1; 浦　春2
（1. 阜阳市人民医院检验科，安徽阜阳 236004；2. 皖南医学院， 安徽芜湖241000）
Author(s):
WANG Wei1;  ZHANG Jing1;  PU Chun 2
（1. Department of Laboratory Medicine, Fuyang People’s Hospital, Anhui Fuyang 236004, China；2. WannanMedical College,Anhui Wuhu 241000, China）
关键词:
妊娠糖尿病; 内脏脂肪组织; 脂肪因子趋化素; 胰岛素抵抗
分类号:
R714.256；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.01.005
文献标志码:
A
摘要:
目的　探讨妊娠糖尿病（ gestational diabetes mellitus，GDM）患者血清、脐血及胎盘组织中的内脏脂肪组织（Visfatin）、脂肪因子趋化素（ Chemerin）的表达变化及与患者发生胰岛素抵抗的关系。方法　选取阜阳市人民医院 2018年 12月～ 2020年 4月妊娠分娩的 GDM孕妇 100例作为 GDM组、糖耐量正常孕妇 100例作为 NGT组。统计分析两组的一般资料、血糖指标、血脂指标，检测两组研究对象血清、脐血、胎盘组织中的 Visfatin，Chemerin表达水平，分析 Visfatin，Chemerin表达与胰岛素抵抗指数（ HOMA-IR）的相关性；通过重组慢病毒载体构建 Visfatin， Chemerin过表达的 3T3-L1脂肪细胞，分析 Visfatin，Chemerin过表达对 3T3-L1脂肪细胞增殖、葡萄糖消耗量、 Akt及 pAkt蛋白表达的影响。结果　GDM 组的 FPG(5.84±0.52mmol/L)，Fins(18.96±3.75μU/ml)，HbA1c(6.42%±0.89%)， HOMA-IR(2.48±0.66)，TC(5.22±0.57mmol/L)和 TG(2.41±0.43mmol/L)测定值均高于 NGT组 (4.61±0.40mmol/L，
Abstract:
Objective　To explore the expression changes of visceral adipose tissue (Visfatin) and adipokines (Chemerin) inserum, cord blood and placental tissue of patients with gestational diabetes mellitus mellitus (GDM) and their relationship withinsulin resistance. Methods　100 pregnant women with GDM in Fuyang People’s Hospital from December 2018 to April 2020were selected as GDM group and 100 pregnant women with normal glucose tolerance (NGT group). The general data, bloodglucose indexes, and blood lipid indexes of the two groups were statistically analyzed. Detected the expression levels of Visfatinand Chemerin in the serum, cord blood, and placental tissues of the two groups of study subjects, and analyzed the correlationbetween Visfatin and Chemerin expression and insulin resistance index (HOMA-IR). Constructed Visfatin by recombinantlentiviral vector, Chemerin overexpression 3T3-L1 adipocytes,and analyzed the effect of Visfatin and Chemerin overexpressionon 3T3-L1 adipocyte proliferation, glucose consumption, Akt and pAkt protein expression. Results　The measured values ofGDM group FPG (5.84±0.52mmol/L), Fins (18.96±3.75μU/ml), HbA1c (6.42%±0.89%), HOMA-IR (2.48±0.66), TC(5.22±0.57mmol/L), TG (2.41±0.43mmol/L) were higher than those of NGT group(4.61±0.40mmol/L，12.53±2.20μU/ml，5.31%±0.70%，1.51±0.42，4.86±0.49mmol/L 和2.18±0.34mmol/L)，the differences were statistically significant（t=18.749, 14.789, 9.803, 12.399, 4.789, 4.196，all P ＜ 0.05）. There was no statistically significant difference between themeasured values of HDL-C（1.64±0.22mmol/L vs 1.70±0.24mmol/L），LDL-C（3.23±0.67 mmol/L vs 3.10±0.54 mmol/L）and ALB（37.84±3.02g/L vs 38.44±3.30 g/L）in the GDM group and the NGT group（t=-1.843, 1.511，-1.341，all P ＞ 0.05）.The Visfatin (10.55±2.41pg/ml，9.87±2.26 pg/ml, 0.421±0.093 /βactin) and Chemerin(233.0±47.6 ng/ml，438.1±95.0ng/ml，1.338±0.207/βactin) measured values in serum, cord blood, and placenta tissue of the GDM group were higher thanthose of the NGT group (6.39±1.05pg/ml，6.11±0.94pg/ml，0.235±0.074/βactin；155.7±30.6ng/ml，218.7±76.8ng/ml，0.905±0.152/βactin) ，the difference was statistically significant (t=13.660~17.960, all P ＜ 0.05).The levels of Visfatinand Chemerin in serum, cord blood, and placental tissues of the GDM group were significantly positively correlated with themeasured values of HOMA-IR (r= 0.357~0.583, all P ＜ 0.05). In cell experiments, the levels of Chemerin overexpression groupand Visfatin overexpression group Glucose consumption of 3T3-L1 adipocytes was lower than Chemerin no-load group andVisfatin no-load group (t=-12.175, 5.319, all P ＜ 0.05); 3T3-L1 adipocytes proliferation A value of Chemerin overexpressiongroup and Visfatin overexpression group were higher than Chemerin no-load group , Visfatin no-load group (t=-13.765, 6.034,all P ＜ 0.05); Chemerin overexpression group, Visfatin overexpression group Akt, the relative expression intensity of pAktprotein was lower than Chemerin no-load group,and Visfatin no-load group (t=-15.938~-10.352, all P ＜ 0.05). Conclusion　Theexpression levels of Visfatin and Chemerin in serum, cord blood, and placental tissues of GDM patients were significantlyincreased, and were positively correlated with insulin resistance. The mechanism of action may be related to down-regulation ofAkt and pAkt protein expression.

参考文献/References:

[1] 赵欣媛, 郑雪绒, 张建华．妊娠期糖尿病患者血清Vaspin, Chemerin 及CRP 水平表达及临床意义[J].中国妇幼保健, 2018,33 (15): 3375-3378.ZHAO Xinyuan, ZHENG Xuerong, ZHANG Jianhua.Expression levels and clinical significance of serumVaspin,Chemerin,and CRP in patients with gestationaldiabetes mellitus [J]. Maternal and Child Health Careof China, 2018,33 (15): 3375-3378.
[2] 张曙晴, 李洪彬, 张骆军, 等．2 型糖尿病患者糖化血红蛋白水平与胰岛素分泌及胰岛素抵抗的关系[J]. 现代检验医学杂志, 2016,31 (2): 108-111．ZHANG Shuqing, LI Hongbin, ZHANG luojun, et al.Correlation between insulin secretion,insulin resistanceand glycosylated hemoglobin levels in patients withtype 2 diabetic [J]. Journal of Modern LaboratoryMedicine, 2016,31 (2): 108-111．
[3] 冯霖, 朱香清, 乔玉芳, 等．妊娠糖尿病患者血清脂联素表达及与炎症因子、胰岛素抵抗关系[J]. 中国计划生育学杂志, 2019,27 (2): 210-212, 217．FENG Lin, ZHU Xiangqing, QIAO Yufang, et al. Theexpression of serum APN of pregnant women withgestational diabetes mellitus and its relationship withinflammatory factors level and insulin resistance [J].Chinese Journal of Family Planning, 2019,27 (2): 210-212, 217．
[4] 杨磊．妊娠期糖尿病内脏脂肪素水平与糖脂代谢关系的研究[J]．实用糖尿病杂志, 2019, 15 (2): 33-34.YANG Lei. A research on correlation between serumvisfatin and glucose and lipid metabolism amongwomen with gestational diabetes mellitus [J]. Journal ofPractical Diabetology, 2019, 15 (2): 33-34．
[5] 焦书文, 周亚茹, 张晓阳, 等．血清脂联素水平和内脏脂肪厚度与妊娠糖尿病的相关性研究[J]．中国临床医生杂志, 2019,47 (11): 1333-1336．JIAO Shuwen, ZHOU Yaru, ZHANG Xiaoyang, etal. Correlation between serum adiponectin level andvisceral fat thickness and gestational diabetes mellitusmellitus [J]. Chinese Journal for Clinicians, 2019,47(11): 1333-1336．
[6] 沈小波, 李盛, 陈伟, 等. 妊娠期糖尿病患者血清FABP4, Nesfatin-1, Chemerin 水平变化及临床意义[J]. 中国妇幼保健, 2019,34 (1): 59-62.SHEN Xiaobo, LI Sheng, CHEN Wei, et al. Changesand clinical significance of serum FABP4, nesfatin-1and Chemerin levels in patients with gestationaldiabetes mellitus mellitus mellitus [J]. Maternal andChild Health Care of China, 2019,34 (1): 59-62.
[7] 魏菊红. 妊娠期糖尿病患者血清FABP4, Chemerin,Nesfatin-1 水平变化及临床意义[J]. 国际医药卫生导报, 2019,25 (22): 3735-3738．WEI Juhong. Changes and clinical significance ofserum FABP4, Chemerin and nesfatin-1 levels inpatients with gestational diabetes mellitus mellitusmellitus [J]. International Medicine and HealthGuidance News, 2019,25 (22): 3735-3738．
[8] 霍琰, 刘素新, 李红艳, 等.Vaspin, IL-6 在妊娠期糖尿病患者胎盘组织中的表达[J]. 中国计划生育和妇产科, 2018, 10(11):79-83.HUO Yan, LIU Suxin, LI Hongyan, et al. Expressionof vaspin and IL-6 in placental tissues of patients withgestational diabetes mellitus [J]. Chinese Journal ofFamily Planning & Gynecotokology, 2018, 10 (11): 79-83.
[9] 王莹, 白凤琴, 周尧．妊娠期糖尿病患者血清胎球蛋白A、胰岛素抵抗指数水平及其临床意义研究[J].中国妇幼保健, 2019,34 (9): 1986-1988．WANG Ying, BAI Fengqin, ZHOU Yao. Levels ofserum fetuin A and insulin resistance index in patientswith gestational diabetes mellitus mellitus mellitusand their clinical significance [J]. Maternal and ChildHealth Care of China, 2019,34 (9): 1986-1988．
[10] ZHOU Zhongwei, CHEN Hongmei, JU Huixiang, etal. Circulating chemerin levels and gestational diabetesmellitus mellitus mellitus: a systematic review andmeta-analysis[J]. Lipids in Health and Disease, 2018,17(1): 169.
[11] ROWAN J A, RUSH E C, PLANK L D, et al.Metformin in gestational diabetes mellitus mellitus: theoffspring follow-up (MiG TOFU): body compositionand metabolic outcomes at 7-9 years of age[J]. BMJOpen Diabetes Research & Care, 2018, 6(1): e000456.
[12] PENG Hangya, LI Haicheng, LIN Shuo, et al.Caveolin-1 was required for glargine to improve insulinsensitivity and activate PI3K/AKT pathway in visceraladipose tissue of type 2 diabetic mice [J]. Diabetes,2018, 67(1): 2423-PUB.
[13] JAYABALAN N, LAI A, ORMAZABAL V, et al.Adipose tissue exosomal proteomic profile reveals arole on placenta glucose metabolism in gestationaldiabetes mellitus mellitus mellitus[J]. The Journal ofClinical Endocrinology and Metabolism, 2019, 104(5):1735-1752.
[14] CRUSELL M K W, HANSEN T H, NIELSEN T, et al..Gestational diabetes is associated with change in the gutmicrobiota composition in third trimester of pregnancyand postpartum[J]. Microbiome, 2018, 6(1): 89.
[15] 雷婷, 涂珺．3T3-L1 脂肪细胞胰岛素抵抗模型研究现状[J]. 江西中医药大学学报, 2018, 30(3):106-109.LEI Ting, TU Jun. Research status on the insulinresistance model of 3T3-L1 adipocytes [J]. Journal ofJiangxi University of Traditional Chinese Medicine,2018, 30 (3): 106-109.
[16] PETRY C J , ONG K K , HUGHES I A , et al.Temporal trends without seasonal effects on gestationaldiabetes mellitus mellitus incidence relate to reductionsin indices of insulin secretion: the Cambridge BabyGrowth Study[J]. Nutrients ,2019, 11(11): 2822.
[17] ROCHA A D S, BERNARDI J R, MATOS S, et al.Maternal visceral adipose tissue during the first halfof pregnancy predicts gestational diabetes mellitusmellitus at the time of delivery–a cohort study[J]. PLoSOne, 2020, 15(4): e232155.
[18] RANCOURT R C, OTT R, ZISKA T, e t al .Visceral adipose tissue inflammatory factors (TNFAlpha,SOCS3) in gestational diabetes mellitusmellitus (GDM): epigenetics as a Clue in GDMpathophysiology[J]. International Journal of MolecularSciences, 2020, 21(2): 479.
[19] LI Zhifang, ZHOU Guiju, JIANG Longfan, et al.Effect of STOX1 on recurrent spontaneous abortion byregulating trophoblast cell proliferation and migrationvia the PI3K/AKT signaling pathway[J]. Journal ofCellular Biochemistry, 2018, 120(5): 8291-8299.
[20] SARWAR M, SYED KHAJA A S, ALESKANDARANYM, et al. The role of PIP5K1α/pAKT and targetedinhibition of growth of subtypes of breast cancer usingPIP5K1α inhibitor[J]. Oncogene, 2019, 38(3): 375-389.
[21] KUGISHIMA Y, YASUHI I, YAMASHITA H, etal. Risk factors associated with the developmentof postpartum diabetes in Japanese women withgestational diabetes mellitus mellitus[J]. BMCPregnancy and Childbirth, 2018, 18(1): 19.

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备注/Memo

备注/Memo:
基金项目：安徽省自然科学基金项目（2008085QH422）。
作者简介：王伟（1977-），男，本科，副主任技师，研究方向：生化、发光免疫，E-mail:wangw197707@163.com。
通讯作者：浦春(1963-)，男，硕士, 主任技师, 研究方向：临床免疫学和分子诊断学。
更新日期/Last Update: 1900-01-01