半乳糖凝集素3在妊娠期糖尿病孕妇中表达及与胰岛素抵抗关系

The expression of galectin-3 of pregnant women with gestational diabetes,and its relationship with insulin resistance

目的:探讨半乳糖凝集素3(Galectin-3)在妊娠期糖尿病(GDM)孕妇外周血以及胎盘组织中的表达特点,分析其与胰岛素抵抗关系。方法:收集2016年2月—2017年12月本院定期产检的116例孕妇为研究对象,依据GDM诊断标准将孕妇分为GDM组(56例),非GDM组(60例),采用稳态效应模型计算胰岛素抵抗指数(HOMA-IR),将GDM组分为胰岛素抵抗组(HOMA-IR≥1.66)(30例)、非胰岛素抵抗组(HOMA-IR<1.66)(26例),分析各组血清Galectin-3水平,采用荧光定量PCR技术、蛋白免疫印迹法检测产妇胎盘Galectin-3mRNA、蛋白表达并分析与血清Galectin-3、HOMA-IR的相关性。结果:血清Galectin-3水平GDM组(32.01±6.17)ng/ml高于非GDM组(8.01±2.05ng/ml),胰岛素抵抗组(42.17±7.85)高于非胰岛素抵抗组(28.14±5.37ng/ml)(均P<0.05)。胎盘组织Galectin-3mRNA表达GDM组(0.71±0.67)高于非GDM组(0.41±0.25),胰岛素抵抗组(0.97±0.85)高于非胰岛素抵抗组(0.54±0.37);Galectin-3蛋白表达水平GDM组(0.81±0.17)高于非GDM组(0.41±0.05),胰岛素抵抗组(1.07±0.83)高于非胰岛素抵抗组(0.64±0.27)(均P<0.05)。Galectin-3mRNA、蛋白表达、血清Galectin-3与HOMA-IR呈正相关(r=0.437、0.357、0.309,P<0.05),Galectin-3mRNA、蛋白表达与血清Galectin-3无关(r=0.019、0.025,P>0.05)。结论:GDM孕产妇血清Galectin-3水平、胎盘组织Galectin-3mRNA、蛋白表达均明显增高,提示GDM有胰岛素抵抗的可能,Galectin-3可作为GDM诊断和治疗的有效指标。

Objective:To explore the expression of Galectin-3 in peripheral blood and placenta tissue of pregnant women with gestational diabetes mellitus(GDM),and to analyze its relationship with insulin resistance.Methods:116 pregnant women who underwent regular pregnancy check in Yiling district maternal and child health care hospital from February 2016 to December 2017 were included in the study.According to the GDM diagnostic criteria,all included pregnant women were divided into GDM group(56 cases)and non GDM group(60 cases).And pregnant women in GDM group were also divided into insulin resistance group(HOMA IR≥1.66,30 cases)and non insulin resistance group(HOMA IR<1.66,26 cases).The insulin resistance index(HOMA IR)was calculated by the steady state effect model.The levels of plasma Galectin-3 of pregnant women in each group were analyzed.The expression of Galectin 3 mRNA and protein in maternal placenta was detected by real time PCR and Western blotting.And the correlation between protein expression and serum Galectin-3 level or HOMA IR were analyzed.Results:The serum Galectin-3 level of pregnant women in GDM group was(32.01±6.17)ng/ml,which was significant higher than that[(8.01±2.05)ng/ml]of pregnant women in non GDM group(P<0.05).The serum Galectin-3 level of pregnant women in insulin resistant group was(42.17±7.85)ng/ml,which was significant higher than that[(28.14±5.37)ng/ml]of pregnant women in non insulin resistance group(P<0.05).The expression of Galectin-3 mRNA in placenta of pregnant women in GDM group was 0.71±0.67,which was significant higher than that(0.41±0.25)of pregnant women in non GDM group(P<0.05).The expression of Galectin-3 mRNA in placenta of pregnant women in insulin resistance group was 0.97±0.85,which was significant higher than that(0.54±0.37)of pregnant women in non insulin resistant group(P<0.05).The expression level of Galectin-3 protein of pregnant women in GDM group was 0.81±0.17,which was significant higher than that(0.41±0.05)of pregnant women in non GDM group(P<0.05).The expression of Galectin-3 protein in placental tissues of pregnant women in insulin resistance group was 1.07±0.83,which was significant higher than that(0.64±0.27)of pregnant women in non insulin resistant group(P<0.05).There were positively correlation between Galectin-3 mRNA,protein expression,or serum Galectin-3 and HOMA IR(r=0.437,0.357,0.309,P<0.05),but there were no correlation between Galectin-3 mRNA or protein expression and serum Galectin 3 level(r=0.019,0.025,P>0.05).Conclusion:The serum level of Galectin-3 and Galectin-3 mRNA in placental,and the protein expression in placental tissues of pregnant women are significantly increased,which means the pregnant women with GDM have possible insulin resistance.So Galectin-3 level can be used as an effective indicator for diagnosing and treating pregnant women with GDM.