[1]孙　红,付翠芳,高佳丽,等.妊娠期糖尿病患者血清miR-21，PPARγ和IGF-1R表达水平与凝血功能和妊娠结局的相关性研究[J].现代检验医学杂志,2021,36(05):143-147.[doi:10.3969/j.issn.1671-7414.2021.05.032]
　SUN Hong,FU Cui-fang,GAO Jia-li,et al.Study on the Correlation between Serum miR-21, PPAR γ and IGF-1R Expression Levels in Patients with Gestational Diabetes and BloodCoagulation Function and Pregnancy Outcome[J].Journal of Modern Laboratory Medicine,2021,36(05):143-147.[doi:10.3969/j.issn.1671-7414.2021.05.032]
点击复制

妊娠期糖尿病患者血清miR-21，PPARγ和IGF-1R表达水平与凝血功能和妊娠结局的相关性研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年05期
页码:
143-147
栏目:
检验与临床
出版日期:
2021-10-14

文章信息/Info

Title:
Study on the Correlation between Serum miR-21, PPAR γ and IGF-1R Expression Levels in Patients with Gestational Diabetes and BloodCoagulation Function and Pregnancy Outcome
文章编号:
1671-7414（2021）05-143-05
作者:
孙　红; 付翠芳; 高佳丽; 霍森烨; 王新月; 王文丽
（邢台市第三医院，河北邢台 054000）
Author(s):
SUN Hong;  FU Cui-fang;  GAO Jia-li;  HUO Sen-ye;  WANG Xin-yue;  WANG Wen-li
（Xingtai Third Hospital, Hebei Xingtai 054000, China）
关键词:
微小RNA-21; 过氧化物酶体增殖物激活受体γ; 胰岛素样生长因子1受体; 妊娠期糖尿病; 凝血功能; 妊娠结局
分类号:
R714.256；R392.11
DOI:
10.3969/j.issn.1671-7414.2021.05.032
文献标志码:
A
摘要:
目的　研究微小RNA-21 (micro RNA21, miR-21)、过氧化物酶体增殖物激活受体γ（peroxisome proliferater-activated receptor γ，PPARγ）和胰岛素样生长因子1受体(insulin 1ike growth factor 1 Receptor, IGF-1R）在妊娠期糖尿病(gestational diabetes mellitus, GDM )中的表达情况及其与凝血功能、妊娠结局的相关性。方法　选取2017年1月~2020年1月在邢台市第三医院妇产科收治的164例GDM患者作为研究对象，同期健康妊娠产妇100例为对照组，收集临床资料、血清标本以及统计妊娠结局。检测受试者血清micro RNA21，PPARγ和IGF-1R水平以及凝血功能，比较两组各指标表达水平差异，采用Pearson相关性分析、多元线性回归分析GDM患者血清Micro RNA21，PPARγ和IGF-1R水平与凝血功能、不良妊娠结局的相关性。结果　GDM组血糖指标水平（空腹OGTT，1h OGTT，2h OGTT，HbAlc，HOMA-IR），FIB，D-D和IGF-1R均明显高于对照组（t=31.456，100.176，69.999，24.948，26.546；11.204，9.753，26.169），PT，APTT，Micro RNA21和PPARγ明显低于对照组（t=4.024，9.958，22.675，51.140），差异均有统计学意义（均P<0.05）。GDM组不良妊娠结局发生率明显高于对照组，差异有统计学意义（χ2=6.472，P<0.05）。Pearson分析显示，Micro RNA21， PPARγ与PT，APTT呈正相关（r=0.418, 0.526, 0.456, 0.603），与FIB，D-D呈负相关（r =-0.582, -0.512, -0.693, -0.587），差异有统计学意义（均P<0.05）。IGF-1R与PT，APTT呈负相关（r= -0.437, -0.571），与 FIB，D-D呈正相关（r=0.604, 0.562），差异均有统计学意义（均P<0.005）。不良妊娠结局产妇的Micro RNA21，PPARγ水平低于妊娠结局良好产妇，而IGF-1R水平高于妊娠结局良好产妇（t=14.575, 30.271, 13.684,均P<0.05）。多元线性回归分析显示Micro RNA21，PPARγ和IGF-1是妊娠结局的独立影响因素（P<0.05）。结论　Micro RNA21，PPARγ和IGF-1R在妊娠期糖尿病患者血清中表达异常，与凝血功能呈相关性，可有效预测GDM患者的妊娠结局。
Abstract:
Objective　To study the expression of Micro RNA21, PPARγ and IGF-1R in gestational diabetes mellitus and theircorrelation with coagulation function and pregnancy outcome. Methods　164 GDM patients admitted to the Department ofObstetrics and Gynecology of the Third Hospital of Xingtai City were selected from February 2017 to April 2020, and 100healthy pregnant women in the same period were selected as the control group. Clinical data, serum samples and pregnancyoutcome were collected. Serum micro RNA21, PPAR, IGF-1R and coagulation function of the subjects were detected, and theexpression levels of each indicator were compared between the two groups. Pearson correlation analysis and multiple linearregression analysis were used to GDM the correlation between serum micro RNA21, PPARγ and IGF-1R level and coagulationfunction and adverse pregnancy outcome. Results　The blood glucose index level (fasting OGTT, 1h OGTT, 2h OGTT, HbAlcand HOMA-IR) of GDM group was significantly higher than that of the control group(t=31.456, 100.176, 69.999, 24.948,26.546), and the PT, APTT, micro RNA21 and PPARγ was significantly lower than that of the control group(t=4.024, 9.958,22.675, 51.140, all P<0.05), while the FIB, D-D and IGF-1R was significantly higher than that of the control group withstatistically significant differences(t=11.204, 9.753, 26.169). The adverse pregnancy outcome was mainly preterm birth,malformation and postpartum hemorrhage, and the incidence of adverse pregnancy outcome in GDM group was significantlyhigher than that in the control group, the difference was statistically significant(χ2=6.472，P<0.05). Pearson analysis showed thatmicro RNA21 and PPARγ were positively correlated with PT and APTT(r= 0.418, 0.526, 0.456, 0.603), and negativelycorrelated with FIB and DD（r = -0.582, -0.512, -0.693, -0.587）. IGF-1R were negatively correlated with PT and APTT（r =-0.437, -0.571）, and positively correlated with FIB and DD（r = 0.604, 0.562）, the differences were statistically significant (allP<0.005). The levels of micro RNA21 and PPARγ in the women with poor pregnancy outcome were lower than those in thewomen with good pregnancy outcome, while the levels of IGF-1R were higher than those in the women with good pregnancyoutcome (t=14.575, 30.271, 13.684, all P< 0.05). Multiple linear regression analysis showed that micro RNA21, PPAR and IGF-1R were the independent factors affecting pregnancy outcome (P<0.05). Conclusion　The expression of micro RNA21, PPARγand IGF-1R were abnormally expressed in serum of patients with gestational diabetes mellitus, which was correlated with bloodcoagulation function, and could effectively predict the pregnancy outcome of patients with GDM.

参考文献/References:

[1] SUN Xiaoting, YANG Lili, PAN Jiexue, et al. Age atmenarche and the risk of gestational diabetes mellitus:a systematic review and meta-analysis[J]. Endocrine,2018, 61(2): 204-209.
[2] 罗明娟, 罗琼, 胡园园, 等. 妊娠期糖尿病联合门诊对妊娠结局获益分析的研究[J]. 中国糖尿病杂志，2018,26(6):441-445.LUO Mingjuan, LUO Qiong, HU Yuanyuan, et al.Effects of GDM joint clinic on the pregnancy outcomes[J]. Chinese Journal of Diabetes ,2018,26(6):441-445.
[3] CHEN Jingci, NAGLE A M, WANG Yufen, et al.Controlled dimerization of insulin-like growth factor-1and insulin receptors reveals shared and distinctactivities of holo and hybrid receptors[J]. Journal ofBiological Chemistry, 2018, 293(10) : 3700-3709.
[4] 李艳, 李新宇. 妊娠糖尿病患者外周血miRNA-21检测的临床应用价值[J]. 现代检验医学杂志,2020,35(2):35-38.LI Yan, LI Xinyu. Clinical application value ofdetection of miRNA-21 in peripheral blood of patientswith gestational diabetes[J].Journal of ModernLaboratory Medicine, 2020,35(2):35-38.
[5] HOSNI A A, ABDEL-MONEIM A A, ABDELREHEIME S, et al. Cinnamaldehyde potentiallyattenuates gestational hyperglycemia in rats throughmodulation of PPARγ, proinflammatory cytokines andoxidative stress[J]. Biomedicine & Pharmacotherapy,2017, 88(1): 52-60.
[6] 马欢, 张冬会, 王杏, 等. 过氧化物酶体增殖物激活受体γ 共激活因子1α 在高脂饮食导致的大鼠骨骼肌线粒体功能紊乱中的作用机制[J]. 中华老年医学杂志,2019,38(4):439-443.MA Huan, ZHANG Donghui, WANG Xing, et al.Mechanisms of peroxisome proliferator-activated receptorgamma coactivator 1α in high-fat diet-induced skeletalmuscle mitochondrial dysfunction in rats [J]. ChineseJournal of Geriatrics, 2019,38(4):439-443.
[7] 赵晓云, 邵凯. 微小RNA-21 在胰岛素抵抗和糖尿病伴发非酒精性脂肪肝发病中的作用[J]. 中国医学科学院学报,2016, 38(2):144-149.ZHAO Xiaoyun, SHAO Kai. Roles of microRNA-21in the pathogenesis of insulin resistance and diabeticmellitus-induced non-alcoholic fatty liver disease [J].Acta Academiae Medicinae Sinicae, 2016, 38(2):144-149.
[8] 谢幸, 苟文丽. 妇产科学[M].8 版. 北京: 人民卫生出版社,2013:64-79.XIE Xing, GOU Wenli. Obstetrics and Gynecology[M].8th Ed. Beijing: People’s Medical Publishing House,2013:64-79.
[9] 王晨, 王雪茵, 杨慧霞. 北京地区妇女分娩年龄与妊娠结局的关系[J]. 中华妇产科杂志,2017,52(8):514-520.WANG Chen, WANG Xueyin, YANG Huixia. Effectof maternal age on pregnancy outcomes in Beijing[J]. Chinese Journal of Obstetrics and Gynecology,2017,52(8):514-520.
[10] 杭航, 王丽琨, 伍国锋, 等. 罗格列酮预处理对凝血酶激活的小胶质细胞PPARγ, Nrf2 及HO-1 表达的影响[J]. 中国病理生理杂志,2016,32(4):671-679.HANG Hang, WANG Likun, WU Guofeng, et al.Rosiglitazone pretreatment influences expressionof PPARγ, Nrf2 and HO-1 in thrombin-activatedmicroglia[J].Chinese Journal of Pathophysiology,2016,32(4):671-679.
[11] 闫园园, 魏剑芬, 李世超, 等. 血清胰岛素样生长因子1 及胰岛素抵抗与2 型糖尿病合并甲状腺功能减退症的相关性研究[J]. 中国全科医学, 2019, 22 (23):2811-2815.YAN Yuanyuan, WEI Jianfen, LI Shichao, et al.Relativity study of insulin-like growth factor 1,insulinresistance and type 2 diabetes with hypothyroidism [J].Chinese General Practice,2019,22(23):2811-2815.
[12] 胡勇, 谭超, 多囊卵巢综合征患者妊娠母血及脐血中胰岛素样生长因子-1 水平对妊娠结局的影响[J].实用医学杂志,2016,32(1):73-75.HU Yong, TAN Chao. Effects of insulin-like growthfactor-1 at varied levels on pregnancy outcomein pregnancy maternal serum and cord serum ofpatients with PCOS [J]. The Journal of PracticalMedicine,2016,32(1):73-75.
[13] 刘嗣超, 武轩迪, 颜红丽. 抵抗素299GA, PPARγPro12Ala 基因多态性与GDM 患者肥胖的相关性[J].中国妇幼保健,2018,33(9):1948-1952.LIU Sichao, WU Xuandi, YAN Hongli, et al.Correlations between gene polymorphisms of resistin299GA,PPARγPro12Ala and obesity in GDM patients[J]. Maternal & Child Health Care of China, 2018,33(9):1948-1952.
[14] MI?KOWIEC D, LIPIEC P, WIERZBOWSKADRABIKK, et al. Association between microRNA-21concentration and lipid profile in patients withacute coronary syndrome without persistent STsegmentelevation[J].Polskie Archiwum MedycynyWewnetrznej, 2016, 126(1/2): 48-57.
[15] LI Yicong, COOPER A, ODIBO I N, et al. Discrepancyin insulin regulation between gestational diabetesmellitus (GDM) platelets and placenta[J]. Journal ofBiological Chemistry, 2016, 291(18) : 9657-9665.
[16] SUN Chuanzheng, HUANG Feizhou, LIU Xunyang,et al. miR-21 regulates triglyceride and cholesterolmetabolism in non-alcoholic fatty liver disease bytargeting HMGCR[J].International Journal of MolecularMedicine, 2015, 35(3): 847-853.
[17] 吴洁丽, 孙沁沁, 陈文殊, 等. 妊娠期糖尿病高龄产妇血清脂联素水平与胰岛素抵抗的相关性研究[J].中华内分泌外科杂志,2017,11(2):143-146.WU Jieli, SUN Qinqin, CHEN Wenshu, et al.Relationship between serum adiponectin concentrationand insulin resistance in elderly pregnancy patients withgestational diabetes mellitus [J]. Journal of EndocrineSurgery, 2017,11(2):143-146.
[18] 孙艺铸, 王静, 于鲁欣, 等. 过氧化物酶体增殖物激活受体-γ/ 核转录因子-κB 转导通路在脓毒症所致凝血功能障碍中的作用[J]．中华危重病急救医学，2015,27(6):520-524.SUN Yizhu, WANG Jing, YU Luxin, et al. The role ofperoxisome proliferator-activated receptor-γ/nuclearfactor-κB transduction pathway on coagulationdisorders induced by sepsis [J]. Chinese Critical CareMedicine,2015,27(6):520-524.

备注/Memo

备注/Memo:
基金项目：河北省邢台市科技计划项目：非糖尿病孕妇与糖尿病孕妇异常妊娠发病率差异性的临床研究（2017ZC083）。
作者简介：孙红（1976-），女，本科/ 学士，主治医师，研究方向：妇产科，E-mail：hongsun.2007@163.com。
通讯作者：王文丽（1982-），女，本科/ 学士，主治医师，研究方向: 妇产科，E-mail：wangwenli588@126.com。
更新日期/Last Update: 1900-01-01