网膜素及内脂素在重度子痫前期患者血清中的表达及意义

Expressions and significances of omentin and visfatin in the serum of the patients with severe preeclampsia

目的探讨重度子痫前期患者血清网膜素、内脂素水平变化及意义。方法重度子痫前期患者30例为观察组,正常妊娠晚期女性30例为对照组;采用ELISA法检测2组血清中网膜素及内脂素水平;记录体质量指数、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖、空腹胰岛素(fasting insulin,FINS)等水平,计算胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR),采用Pearson分析法分析血清网膜素、内脂素与三酰甘油、FINS等的相关性。结果观察组总胆固醇[(5.70±1.01)mmol/L)]、三酰甘油[(3.75±1.01)mmol/L)]、低密度脂蛋白胆固醇[(3.17±1.06)mmol/L]、FINS[(28.21±9.25)mU/L]、HOMA-IR[5.63(4.84,7.66)]、内脂素水平[(63.73±17.33)μg/L)高于对照组[(5.03±0.97)mmol/L、(2.69±0.80)mmol/L、(1.98±0.73)mmol/L、(8.77±3.16)mU/L、1.53(1.13,2.50)、(34.67±9.17)μg/L],高密度脂蛋白胆固醇[(1.81±0.57)mmol/L]、血清网膜素水平[(19.53±5.40)μg/L]低于对照组[(2.29±0.84)mmol/L、(29.10±5.47)μg/L](P<0.01),2组空腹血糖水平比较差异无统计学意义(P>0.05);观察组血清网膜素水平与三酰甘油(r=-0.374,P=0.042)、FINS(r=-0.471,P=0.009)、HOMA-IR(r=-0.381,P=0.038)均呈负相关,内脂素水平与三酰甘油(r=0.370,P=0.044)、FINS(r=0.499,P=0.005)、HOMA-IR(r=0.459,P=0.011)均呈正相关。结论重度子痫前期患者存在明显血脂代谢异常和胰岛素抵抗,血清网膜素及内脂素水平的变化可能通过影响血脂代谢及胰岛素抵抗参与子痫前期的发病和进展。

Objective To explore the changes and significances of the serum levels of omentin and visfatin in severe preeclampsia （PE）. Methods The serum levels of omentin and visfatin were detected by ELISA in 30 patients with severe PE （observation group） and 30 normal women in third trimester of pregnancy （control group）. The body mass index （BMI）, total cholesterol （TC）, triacylglycerol （TG）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, fasting plasma glucose and fasting insulin （FINS） were detected, and homeostasis model assessment-insulin resistance （HOMA-IR） was calculated. Pearson analysis method was used to study the correlations of omentin and visfatin with TG and FINS. Results The levels of TC, TG, LDL-C, FINS, HOMA-IR and visfatin were significantly higher in observation group （（5.70±1.01）mmol/L, （3. 75±1. 01）mmol/L, （3. 17±1.06） mmol/L, （28.21±9.25）mU/L, 5.63（4.84,7.66）, （63.73±17.33）ug/L） than those in control group （（5.03±0.97） mmol/L, （2.69±0. 80）mmol/L, （1. 98±0. 73）mmol/L, （8.77±3.16）mU/L, 1.53（1.13,2.50）,（34.67±9.17）ug/L） （P〈0.05）, while the HDL-C and omentin levels were significantly lower （（1. 81±0. 57） mmol/L, （19. 53±5.40）ug/L） than those in control group （（2.29±0.84）mmol/L, （29. 10±5.47）ug/L） （P〈0.01）. There was no significant difference in fasting plasma glucose level between two groups （P〉0.05）. The serum level of omentin was negatively correlated with the serum TG （r=-0. 374, P=O. 042）, FINS （r=-0. 471, P=O. 009） and HOMA IR （r=-0. 381, P=0. 038） （P〈0.01）, and the serum level of visfatin was positively correlated with the serum TG （r= 0.370, P=0.044）, FINS （r= 0.499, P= 0.005） and HOMA-IR （r=0.459, P=0.011） in observation group. Conclusion Dyslipidemia and insulin resistance occur in patients with severe PE, and the omentin and visfatin expressions may participate in the pathogenesis of PE by influencing lipid metabolism and insulin resistance.