子痫前期患者A-FABP表达水平与胰岛素抵抗相关性研究

Study on the correlation between expression level of A-FABP and insulin-resistance in the patients with preeclampsia

目的探讨子痫前期患者脂肪细胞型脂肪酸结合蛋白(A-FABP)水平与稳态模型胰岛素抵抗(HOMA-IR)的相关性及子痫前期发生的可能机制。方法选取2013年10月至2015年10月于西安市中心医院妇产科就诊的76例子痫前期患者(轻度子痫前期42例,重度子痫前期34例)作为病例组,选择同期健康孕妇48例作为对照组。采用酶联免疫吸附试验、免疫组织化学法及全自动生化仪检测所有研究对象血清AFABP、空腹胰岛素(FINS)、胎盘组织A-FABP、空腹血糖(FBG)等指标,计算HOMA-IR。分析子痫前期患者血清及胎盘A-FABP水平与HOMA-IR的相关性。结果子痫前期患者的血清及胎盘A-FABP水平、FINS及HOMA-IR明显高于对照组,且重度子痫前期患者的血清及胎盘A-FABP水平、FINS及HOMA-IR明显高于轻度子痫前期组,差异有统计学意义(P<0.05);相关性分析发现,胎盘A-FABP表达强度与血清A-FABP水平呈正相关(r=0.054,P<0.01),且血清及胎盘A-FABP水平均与HOMA-IR呈正相关(P<0.01)。结论子痫前期患者体内A-FABP水平及HOMA-IR均升高且A-FABP水平与胰岛素抵抗呈正相关,提示AFABP对HOMA-IR的调节可能是导致子痫前期发生、进展的原因。

Objective To explore the relationship between the level of A-FABP and HOMA-IR in the patients with preeclampsia and the pathogenesis of preeclampsia.Methods Seventy-six pregnancies diagnosed with preeclampsia in obstetrical department from october 2013 to october 2015 were selected as preeclampsia(42 cases of mild preeclampsia,34 cases of severe preeclampsia),and forty-eight pregnant women with normal pregnancy in the same period were selected as control group.The serum level of A-FABP,fasting insulin(FINS),placenta tissue level of A-FABP,fasting blood glucose(FBG)were detected using enzyme linked immunosorbent assay(ELISA),immunohistochemistry and full automatic biochemical analyzer,and homeostatic model assessment insulin resistance(HOMA-IR)was calculated.The relationship between the serum and placenta levels of A-FABP and HOMA-IR were contrastively analyzed.Results The serum and placenta levels of A-FABP,FINS and HOMA-IR in preeclampsia group were significantly higher than those in the control group,and the serum and placenta levels of A-FABP,FINS and HOMA-IR in severe preeclampsia were also significantly higher than those in the mild preeclampsia(P<0.05);The results of correlation analysis indicated that the placental level of A-FABP was positively correlated with the serum level of A-FABP(P<0.01),and the serum and placentalevels of A-FABP were positively correlated with HOMA-IR in preeclampsia(P<0.01).Conclusion The levels of A-FABP and HOMA-IR increase in preeclampsia,and the levels of A-FABP were positively correlated with HOMA-IR.The high levels of A-FABP increase insulin resistance,indicating that this maybe involved in the pathogenesis of preeclampsia.