脑源性神经营养因子基因多态性与妊娠糖尿病及新生儿早产的关系

Relationship between brain-derived neurotrophic factor gene polymorphism and gestational diabetes mellitus and neonatal premature delivery

目的探讨脑源性神经营养因子(BDNF)基因多态性与妊娠糖尿病(GDM)及新生儿早产的关系。方法前瞻性收集1196例妊娠妇女,根据糖耐量试验检测结果分糖耐量正常组(GNGT组)、糖耐量异常组(GIGT组)和妊娠糖尿病组(GDM组)。比较三组生化指标检测结果,采用RT-PCR分析不同组别BDNF(rs10767664)多态性与GDM的关系,采用Kalplan-Meier生存分析比较不同基因型GDM孕妇进展为T2DM情况。结果 GDM组空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)明显高于GIGT组、GNGT组,高密度脂蛋白胆固醇(HDL-C)、BDNF明显低于GIGT组、GNGT组,三组比较,差异均有统计学意义(P<0.05);GDM组TT型频率、T等位基因频率明显高于GIGT组、GNGT组,差异有统计学意义 P<0.05);Logistic回归分析显示,TT基因型较AA基因型发生GDM的风险升高1.59倍(OR=1.586,95%CI:1.113~4.624)。GDM组TT型妊娠结局中胎膜早破、早产儿比率均高于AA、AT型,差异有统计学意义(P<0.05)。TT基因型GDM孕妇进展为T2DM的累积风险发生率高于AA型GDM孕妇,差异有统计学意义(Log rank χ^2=7.771,P<0.05),与AT型比较,差异无统计学意义(Log rank χ^2=1.693,P>0.05)。结论 BDNF(rs10767664)基因多态性与GDM及新生儿早产有一定关系,临床值得进一步研究。

Objective To investigate the relationship between brain-derived neurotrophic factor gene polymorphism and gestational diabetes mellitus and neonatal premature delivery. Methods A total of 1 196 pregnant women were enrolled in this study. According to the results of glucose tolerance test,the normal glucose tolerance group (GNGT group),the glucose tolerance group (GIGT group) and the gestational diabetes group (GDM group) were used to analyze different groups of BDNF by RT-PCR.(rs10767664) Polymorphism and the relationship between GDM,neonatal premature delivery. Results There were significant differences in FPG,HbA1c,TC,LDL-C,HDL-C,HOMA-IR and BDNF between GDM group and GIGT group and GNGT group ( P <0.05);TT genotype frequency and T allele frequency in GDM group were significantly different from GIGT group and GNGT group ( P <0.05). The risk of GDM was 1.59 times higher than that of the AA genotype (OR=1.586,95%CI:1.113~4.624). The percentage of premature rupture of membranes and premature infants in GDM group was higher than that in AA and AT group ( P <0.05). The cumulative risk of developing T2DM in TT genotype GDM was higher than that in AA genotype GDM (Logrank χ^2=7.771, P <0.05),and there was no significant difference between TT genotype GDM and AT genotype GDM (Logrank χ^2=1.693, P >0.05). Conclusion BDNF (rs10767664) polymorphism is related to GDM and neonatal premature delivery it is worthy of further study.