TNF－α基因多态性与妊娠期糖尿病相关性研究

A study on the association between tumor necrosis factor polymorphism and gestational diabetes mellitus

目的：研究肿瘤坏死因子α（TNF-α）－308G／A启动子基因多态性与妊娠期糖尿病（GDM）发病的关系。方法应用聚合酶链反应－限制性片段长度多态性法（ PCR－RFLP）检测TNF－α－308G／A在GDM患者（50例）及正常妊娠孕妇（50例）中的基因型及基因频率，并记录空腹血糖、空腹胰岛素、血清TNF－α水平、腰臀比、体重指数、胰岛素抵抗指数等临床及生化指标。结果 GDM组体重指数、血清TNF－α水平、胰岛素抵抗指数均高于对照组，差异有统计学意义（ P＜0．05）。 GDM组GA＋AA基因型出现频率明显高于对照组，A等位基因出现频率明显高于对照组，差异有统计学意义（ P＜0．05）。 GA＋AA基因型患者的血清TNF－α水平、胰岛素抵抗指数明显高于GG基因型患者，差异有统计学意义（ P＜0．05）。结论 TNF－α－308G／A启动子基因多态性与GDM发病有关，其机制可能是通过升高GDM患者TNF－α水平，产生胰岛素抵抗而导致GDM的发生。

Objective To investigate the association between tumor necrosis factorα（ TNF-α） promoter-308G/A polymorphism and the pathogenesis of gestational diabetes mellitus （GDM）.Methods A total of 50 GDM patients and 50 normal pregnant women were included in the current study.Their allele frequency and genotype distribution of TNF-α308G/A were examined by polymerase chain reaction-restriction fragment length polymorphism （ PCR-RFLP） .Meanwhile, their biochemical data such as fasting blood glucose, fasting insulin, serum TNF-αlevels, waist-to-hip ratio, body mass index and insulin resistance index were recorded.Results GDM patients presented signifi-cant increases in BMI, serum TNF-αlevel and insulin resistance index, compared with the control （P〈0.05）.The frequency of （ GA＋AA） genotype and the frequency of allele A were remarkably higher in the GDM group than in the control group （P〈0.05）.GA＋AA genotype carriers showed marked increases in serum TNF-αlevel and insulin re-sistance index, compared with patients with GG genotype （P〈0.05）.Conclusions The polymorphism of TNF-α-308G/A promoter is associated with the pathogenesis of GDM, where GDM women may produce elevated levels of serum TNF-αand cause insulin resistance and GDM.