血清中脂联素水平变化及脂肪组织中脂联素mRNA表达与子痫前期发病的关系

Maternal serum level of adiponectin and expression of adiponectin mRNA in subcutaneous and omental adipose tissues in women with preeclampsia

目的探讨子痫前期孕妇血清脂联素水平变化及腹壁皮下、大网膜脂肪组织中脂联素mRNA表达与子痫前期发病的关系。方法选择2007年9月—2008年7月福建省妇幼保健院妇产科住院分娩的孕妇79例，其中49例重度子痫前期孕妇按发病时孕周不同分为早发型组24例（发病时孕周≤34周）；晚发型组25例（发病时孕周〉34周）；30例正常晚期妊娠妇女为对照组。采用RT—PCR技术检测3组孕妇腹壁皮下、大网膜脂肪组织中脂联素mRNA的表达水平；采用酶联免疫吸附（EHSA）法检测3组孕妇血清中脂联素水平。检测临床相关指标，包括血压、血脂及孕前体重等，并进行相关性分析。结果（1）早发型组及晚发型组孕妇血清中脂联素水平分别为（5．9±2．7）及（7．9±2．8）mg/L，分别与对照组的（11．2±4．2）mg／L比较，差异均有统计学意义（P〈0．01）；且早发型组低于晚发型组，两组比较，差异有统计学意义（P〈0．05）。（2）早发型组及晚发型组孕妇腹壁皮下脂肪组织中脂联素mRNA表达水平分别为0．90±0．19及0．93±0．23，分别与对照组的1．00±0．16比较，差异均无统计学意义（P〉0．05）；早发型组及晚发型组孕妇大网膜脂肪组织中脂联素mRNA表达水平分别为0．56±0．17及0．69±0．23，分别与对照组的1．00±0．22比较，差异也均有统计学意义（P〈0．01），且早发型组低于晚发型组，两组比较，差异有统计学意义（P〈0．05）。（3）早发型组、晚发型组及对照组孕妇腹壁皮下及大网膜脂肪组织中脂联素mRNA表达水平与血清脂联素水平均呈正相关（P〈0．05）。（4）早发型组、晚发型组及对照组孕妇大网膜脂肪组织中脂联素mRNA表达水平与血甘油三酯（TG）呈明显负相关，相关系数分别为-0．610、-0．659及-0．446（P均〈0．05）；对照组孕妇大网膜脂肪组织中脂联素mRNA表达水平与孕前体重指数呈明显负相关（r=-0．436，P〈0．05）。结论子痫前期孕妇血清脂联素水平降低，提示其可能参与了子痫前期的病理生理过程；而子痫前期孕妇大网膜脂肪组织中脂联素mRNA表达水平显著下降，可能是子痫前期孕妇血清脂联素水平下降的主要原因。

Objective To determine the expression of adiponectin mRNA in omental and subcutaneous adipose tissues and serum levels of adiponectin in pregnant women complicated with pre- eclampsia （PE） in order to find out its association with the pathogenesis of PE. Methods The expression of adiponectin mRNA in omental and subcutaneous adipose tissue of 49 women with severe PE, which were divided into early-onset group （ n = 24, presented at ≤34 weeks of gestation） and late-onset group （ n = 25, presented at 〉 34 weeks of gestation）, and 30 healthy pregnant women （control）, who presented to Fujian Maternity and Child Health Hospital for prenatal care from September 2007 to July 2008, were determined by real-time fluorescent quantitative reverse transcription PCR. The maternal serum level of adiponeetin was detected by enzyme-linked immunosorbent assay for all subjects. Results （i）The levels of serum adiponectin in the early-onset and late-onset severe PE groups were （ 5.9 ± 2. 7 ） and （ 7.9 ± 2. 8 ） mg/L, which were significantly lower than that of the control （ 11.2 ± 4. 2） mg/L, respectively （ P 〈 0. 01 ）, and the level in the early-onset group was lower than in the late-onset group （P 〈 0. 05 ）. （ 2 ） Among the early-onset, late-onset PE group and the controls, significant difference was found between any two groups of the three in the adiponectin mRNA expression in omental adipose tissue （0. 56 ± 0. 17, 0. 69 ±0. 23 and 1.00 ± 0. 22, P 〈 0. 01 ）, but not in the subcutaneous adipose tissue （0. 90 ± 0. 19, 0. 93 ± 0. 23 and 1.00 ± 0. 16, P 〉 0. 05 ）. （3）The adiponectin mRNA expressions in the subcutaneous and omental adipose tissue were positively correlated with the maternal serum level of adiponectin in all groups（ P 〈 0. 05 ）. （d）The omental adiponectin mRNA levels were negatively correlated with maternal serum triglyceride levels in all of the three groups （r = -0. 610, -0. 659, -0. 446, respectively, and all P 〈 0. 05）. Negative correlation was also found between the omental adiponectin mRNA level and the prepregnant body mass index in the control group （ r = - 0. 436, P 〈 0. 05 ）. Conclusion Decreased maternal serum adiponectin level may be involved in the pathogenesis of pre-eclampsia and also may contribute to the reduced expression of adiponectin in the omental adipose tissue.