妊娠期糖尿病患者胎盘组织中趋化素、胰岛素受体底物1、胰岛素受体底物2和磷酸化蛋白激酶B的表达及与胰岛素抵抗的关系

The relationship between the expression of Chemerin, IRS-1, IRS-2 and p-Akt and insulin resistance in the placenta in pregnant women with GDM

目的检测GDM患者胎盘组织中趋化素(Chemerin)、IRS-1、IRS-2及磷酸化蛋白激酶B(p-Akt)的表达,分析Chemerin与IRS-1、IRS-2及p-Akt的相关性并探讨其与IR的关系。方法选取2017年4月1日至2019年6月10日于昆明医科大学第一附属医院产科规律产检并分娩的单胎妊娠孕妇44例,分为GDM组22例及正常对照组(NGT组)22例,剖宫产术中收集胎盘组织1 g,Western blot方法检测胎盘组织中Chemerin、IRS-1、IRS-2及p-Akt的蛋白表达。结果与NGT组比较,GDM组Chemerin表达升高[0.644(0.177,1.085)vs 0.303(0.065,0.382),P=0.021],IRS-1表达降低[0.081(0.009,0.273)vs 0.184(0.078,0.640),P=0.04],p-Akt降低[0.369(0.266,1.120)vs0.852(0.419,3.307),P=0.03],两组IRS-2表达差异无统计学意义[0.125(0.032,0.659)vs 0.202(0.060,0.565),P=0.66]。Spearman相关分析显示,Chemerin与IRS-1及p-Akt蛋白表达呈负相关(r=―0.363、―0.445,P=0.003、0.005)。线性逐步回归分析显示,p-Akt是胎盘组织中Chemerin的独立影响因素(β=0.525,P=0.012);IRS-2是p-Akt的独立影响因素(β=0.603,P=0.001)。结论GDM患者胎盘组织中Chemerin蛋白表达升高,IRS-1/p-Akt蛋白表达降低,与IR密切相关。

Objective To investigate the relationship between Chemerin and IRS-1,IRS-2 and p-Akt,and to explore the association between Chemerin and insulin resistance(IR)in patients with GDM by testing the expression of Chemerin,IRS-1,IRS-2 and p-Akt in placental tissues.Methods A total of44 women with singleton pregnancy were enrolled in this study from the Department of Obstetric and Gynecology in the 1 st Affiliated Hospital of Kunming Medical University from April 1 st,2017 to June 10 th,2019.All the participants finished the scheduled pregnancy check up and labor in this department,and divided into two groups:GDM group(n=22)and the normal glucose tolerance group(NGT,n=22).One gram of placental tissues was collected during cesarean section.The protein expressions of chemerin,IRS-1,IRS-2 and p-Akt in placental tissues were detected by Western blot.Results The expression of chemerin[0.644(0.177,1.085)vs 0.303(0.065,0.382),P=0.021]was significantly higher,while the expression of IRS-1[0.081(0.009,0.273)vs 0.184(0.078,0.640),P=0.04]and p-Akt[0.369(0.266,1.120)vs0.852(0.419,3.307),P=0.03]were significantly lower in GDM group than in NGT group.There was no significant difference in IRS-2[0.125(0.032,0.659)vs 0.202(0.060,0.565),P=0.66]expression between the two groups.Association analysis showed that Chemerin was negatively correlated with IRS-1 expression(r=―0.363,P=0.003)and p-Akt protein(r=―0.445,P=0.005).Linear stepwise regression analysis revealed that the expression of p-Akt in placental tissues was an independent predictor for Chemerin(β=0.525,P=0.012),and IRS-2 protein expression(β=0.603,P=0.001)was also an independent predictor for p-Akt expression.Conclusion The significant increase in Chemerin expression and the decrease in IRS-1/p-Akt expression in placental tissues were closely related to IR in GDM.