IRS-1和GLUT4在妊娠期糖尿病患者胎盘组织中的表达水平及其临床意义

Expression and clinical significance of IRS-1 and GLUT4 in placental tissues of patients with gestational diabetes mellitus

目的探讨胰岛素受体底物-1(IRS-1)和葡萄糖转运蛋白4(GLUT4)在妊娠期糖尿病(GDM)患者胎盘组织中的表达水平及其临床意义。方法60例GDM患者为GDM组,同期体检健康的同孕龄孕妇52例为对照组,检测两组孕妇糖脂代谢、血压、新生儿体重等,胎盘组织中IRS-1和GLUT4表达水平应用免疫组织化学方法检测。结果GDM组胰岛素抵抗指数(HOMA-IR)高于对照组(P<0.05),胰岛素敏感指数(HOMA-ISI)、胰岛β细胞功能(HOMA-β%)均较对照组偏低(P<0.05);GDM组胎盘组织中IRS-1阳性表达率、GLUT4阳性表达率低于对照组(P<0.05);IRS-1、GLUT4表达水平与HOMA-IR、HOMA-β%呈负相关(P<0.05),与HOMA-ISI呈正相关(P<0.05);IRS-1表达水平与GLUT4呈正相关(P<0.05);胎盘组织中IRS-1、GLUT4表达异常是妊娠妇女发生GDM的独立危险因素(P<0.05)。结论胎盘组织中IRS-1、GLUT4表达减弱是妊娠妇女发生GDM的独立危险因素。

Objective To explore the expression and clinical significance of insulin receptor substrate-1(IRS-1)and glucose transporter 4(GLUT4)in placental tissues of patients with gestational diabetes mellitus(GDM).Methods 60 GDM patients were selected as the GDM group.52 healthy women with the same gestational age were selected as the control group.Glucolipid metabolism,blood pressure and neonatal weight were detected,and immunohistochemistry was used to detect the expression levels of IRS-1 and GLUT4 in placental tissues.Results The insulin resistance index(HOMA-IR)in GDM group was higher than that in control group(P<0.05),while the insulin sensitivity index(HOMA-ISI)and isletβ-cell function(HOMA-β%)were lower than those in control group(P<0.05).The positive expression rates of IRS-1 and GLUT4 in placental tissues in GDM group were lower than control group(P<0.05).The expression levels of IRS-1 and GLUT4 were negatively correlated with HOMA-IR and HOMA-β%(P<0.05),and were positively correlated with HOMA-ISI(P<0.05).The expression level of IRS-1 was positively correlated with GLUT4(P<0.05).The abnormal expressions of IRS-1 and GLUT4 in placental tissues were independent risk factors for GDM(P<0.05).Conclusion The decreases of expressions of IRS-1 and GLUT4 in placental tissues are independent risk factors for GDM.