妊娠期糖尿病母血及脐血血清和胎盘中YKL-40的表达及意义

Expression and Significance of YKL-40 in Maternal Blood and Umbilical Cord Blood Serum and Placenta in Patients with Gestational Diabetes Mellitus

目的通过检测GDM患者母血血清、脐血血清和胎盘组织中人类软骨糖蛋白39(YKL-40)的表达情况,为探讨GDM的发病机理提供理论依据。方法采用ELISA和免疫组化检测随机选取2015年1—12月于扬州市妇幼保健院产科病房分娩的对照组正常孕妇20名和GDM组GDM患者60例母血血清、脐血血清和胎盘组织中YKL-40的表达水平。结果 (1)YKL-40蛋白主要表达于胎盘绒毛合体滋养细胞与血管内皮细胞的胞浆,胞核。YKL-40在对照组产妇静脉血清中的表达量为(0.369 2±0.003 2)pg/m L,脐静脉血清中的表达量为(0.336 7±0.003 1)pg/m L,GDM产妇血清中的表达量为(0.405 1±0.002 1)pg/m L,脐血中的表达量为(0.404 2±0.002 4)pg/m L,GDM患者母血血清、脐血血清中的YKL-40的表达水平均显著高于对照组,差异有统计学意义(P<0.01)。(2)GDM组胎盘组织中YKL-40表达水平显著高于对照组,差异有统计学意义(P<0.01)。结论 GDM患者母血血清、脐血血清和胎盘组织中YKL-40的表达水平均明显高于正常对照组,YKL-40可能与GDM发病有关,GDM的发病可能与炎症刺激相关,为GDM的早期预测、诊断及治疗提供线索。

Objective To detect the expression of 39（YKL-40）in the maternal blood and umbilical cord blood serum and placenta in patients with gestational diabetes mellitus and provide theoretical basis for studying the pathogenesis of GDM.Methods The YKL-40 expression levels in maternal blood and umbilical cord blood serum and placenta in 20 cases of normal delivery women in the control group and 60 cases of GDM patients in the GDM group in our hospital which randomly selected from January to December 2015 were tested by the ELISA and immunohistochemical test. Results The expression of YKL-40 protein was mainly in the cytoplasm and nucleus in the placental syncytiotrophoblast and vascular endothelial cells, the expression level of YKL-40 in the venous serum in the control group was（0.369 2±0.003 2）pg/mL and in the umbilical cord venous serum was（0.336 7±0.003 1）pg/mL, the expression level of YKL-40 in the venous serum in the GDM group was（0.405 1±0.002 1）pg/mL and in the umbilical cord venous serum was（0.404 2±0.002 4）pg/mL,and the expression level of YKL-40 in maternal blood and umbilical cord blood serum of GDM patients were obviously higher than that in the control group, and the difference was obvious with statistical significance（P〈0.01）, and the expression level of YKL-40 in the placenta tissues in the GDM group was obviously higher than that in the control group, and the difference was obvious with statistical significance（P〈0.01）. Conclusion The expression level of YKL-40 in maternal blood and umbilical cord blood serum and placenta in patients with gestational diabetes mellitus is obviously higher than that in the normal control group, and the YKL-40 may be related to the attack of GDM, and the attack of GDM is related to the disease incitement thus providing clue for the early prediction, diagnosis and treatment of GDM.