胎盘组织中IGF-1和IGF-2表达水平与妊娠期糖尿病巨大儿发生的相关研究

Correlation between expression of IGF-1 and IGF-2 in placenta and the occurrence of gestational diabetes mellitus

目的探讨妊娠期糖尿病(GDM)巨大儿与胎盘组织中胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子-2(IGF-2)表达水平的相关性。方法选取2014年4月~2016年12月在南京医科大学附属妇产医院产科住院并确诊为GDM的初产妇分娩的巨大儿40例为GDM巨大儿组,同期健康初产妇分娩的巨大儿40例为健康巨大儿组,同期健康初产妇分娩的正常体重儿40例为对照组。比较三组新生儿胎盘组织中IGF-1和IGF-2表达水平,分析IGF-1和IGF-2表达水平与GDM巨大儿发生的相关。结果 GDM巨大儿组胎盘组织中IGF-1、IGF-2 mRNA表达水平均显著高于健康巨大儿组及对照组(P<0.01),健康巨大儿组与对照组间胎盘组织中IGF-1、IGF-2 mRNA水平差异无统计学意义(P>0.05);二元Logistic回归分析结果发现:IGF-1、IGF-2水平为GDM巨大儿发生的危险因素(OR=3.490,95%CI:2.537~6.928,P=0.017;OR=2.077,95%CI:1.098~4.997,P=0.023)。结论 GDM巨大儿患者胎盘组织中IGF-1、IGF-2表达水平显著增高,IGF-1、IGF-2表达水平与GDM巨大儿的发生显著相关。

Objective To explore the correlation of gestational diabetes mellitns （GDM） macrosomia with the expression of insulin-like growth factor-1 （IGF-1） and insulin-like growth factor-2 （IGF-2）. Methods Forty neonates with macrosomia given birth by primiparas who were admitted to Department of Obstetrics of the Affiliated Maternity Hospital of Nanjing Medical University from April 2014 to December 2016 and confirmed with GDM were assigned to the GDM macrosomia group, 40 neonates with macrosomia given birth by healthy primiparas over the same period were assigned to the healthy macrosomia group, and 40 neonates with normal weigh given birth by healthy primiparas over the same period were assigned to the control group. The expression of IGF-1 and IGF-2 in the neonate＇s placenta was compared between the three groups, and the correlation of IGF-1 and IGF-2 expression with the development of GDM macroso- mia was analyzed. Results Expression of IGF-1 and IGF-2 mRNA in placenta was significantly higher in GDM macrosomia group than that in healthy macrosomia group and control group （P 〈 0.01）, and there were no statistically significant differences between healthy macrosomia group and control group in the levels of IGF-1 or IGF-2 mRNA （P 〉 0.05）; binary Logistic regression analysis identified IGF-1 and IGF-2 levels as the risk factors for macrosomia in GDM （OR = 3.490, 95%CI： 2.537-6.928, P = 0.017; OR = 2.077,95%CI： 1.098-4.997, P = 0.023）. Conclusion Expression of IGF- 1 and IGF-2 in placenta is significantly elevated in patients with GDM macrosomia; expression of IGF-1 and IGF-2 is significantly correlated with the development of GDM macrosomia.