子痫前期患者血清内脂素、肿瘤坏死因子α水平与胰岛素抵抗的相关性

Serum levels of visfatin and tumor necrosis factor-alpha in patients with pre-eclampsia and their relationship with insulin resistance

目的:探讨子痫前期患者血清内脂素及肿瘤坏死因子-α(TNF-α)与胰岛素抵抗(IR)的关系。方法:根据子痫前期分类标准选取重度子痫前期患者30例、轻度子痫前期患者30例及正常孕妇40例。采用酶联免疫吸附试验(ELISA)法检测孕妇血清内脂素和TNF-α浓度,血浆葡萄糖氧化酶法测定空腹血糖(FBG),放射免疫法测定空腹胰岛素(FIns),全自动生化分析仪测定血浆甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平。通过计算平均动脉压(MAP)、体质量指数(BMI)和胰岛素抵抗指数(HOMA-IR),分析子痫前期患者血清内脂素、TNF-α水平与IR的关系。结果:重度、轻度子痫前期患者的血清内脂素和TNF-α浓度低于正常孕妇(P<0.05),且重度子痫前期患者的血清内脂素和TNF-α浓度低于轻度子痫前期患者(P<0.05);血清内脂素与TNF-α、HDL-C呈正相关(P<0.05),与MAP、FIns呈负相关(P<0.05);血清TNF-α与HDL-C呈正相关(P<0.05),与BMI、TG、MAP、FIns呈负相关(P<0.05)。多元逐步线性回归分析显示,FBG、FIns和HOMA-IR是影响血清内脂素及TNF-α水平的相关因素。结论:子痫前期患者血清内脂素、TNF-α水平与IR密切相关。

AIM： To explore the serum levels of visfatin（ VF） and tumor necrosis factor-alpha（ TNF-α） in the patients with pre-eclampsia（ PE） and their correlation with insulin resistance（ IR）. METHODS： The severe PE patients（ n = 30）,mild PE patients（ n = 30） and normal pregnant women（ n = 40） were selected according to the classification standard of PE. The serum levels of VF and TNF-α were measured by ELISA. Fasting plasma glucose（ FPG） and fasting insulin（ FIns） were detected by glucose oxidase method and radioimmunoassay,respectively. Triglyceride（ TG）,total cholesterol（ TC）,high-density lipoprotein cholesterol（ HDL-C） and low-density lipoprotein cholesterol（ LDL-C）were measured by an automatic biochemical analyzer. According to calculating the mean arterial pressure（ MAP）,body mass index（ BMI） and homeostatic model assessment for insulin resistance index（ HOMA-IR）,the correlation between IR and the levels of serum VF as well as TNF-α were analyzed. RESULTS： The levels of VF and TNF-α in severe PE group and mild PE group were significantly lower than those in normal pregnancy group（ P〈0. 05）. In addition,the levels of VF and TNF-α in severe PE group were lower than those in mild PE group（ P〈0. 05）. Linear correlation analysis showed that serum VF was positively correlated with TNF-α and HDL-C（ P〈0. 05）,and negatively with MAP and FIns（ P〈0. 05）.The serum TNF-α was positively correlated with HDL-C（ P〈0. 05）,and negatively with BMI,TG,MAP and FIns（ P〈0. 05）. Multiple stepwise regression analysis showed that FBG,FIns and HOMA-IR were relative independent factors of serum VF and TNF-α（ P〈0. 05）. CONCLUSION： Serum levels of VF and TNF-α are closely related to IR.