胎盘11β-羟类固醇脱氢酶表达水平与妊娠期糖尿病相关性

Relationship between the expression level of placenta 11 beta-HSDs of pregnant women and their gestational diabetes mellitus

目的:探讨胎盘11β-HSDs表达水平与妊娠期糖尿病相关性。方法:选取2018年1月—2019年4月本院分娩的产妇704例,其中未发生妊娠期糖尿病598例(对照组)、发生妊娠期糖尿病106例(糖尿病组)。检测两组胎盘11β-羟类固醇脱氢酶(11β-HSDs)表达及皮质醇变化,分析与妊娠期糖尿病关系。结果:糖尿病组空腹胰岛素、胰岛素分泌指数高于对照组,母血皮质醇水平高于对照组(P<0.05),脐血皮质醇与新生儿体质量两组无差异(P>0.05);糖尿病组胎盘组织中11β-HSD1阳性率(67.9%)高于对照组(5.4%)。免疫组化分析,糖尿病组胎盘组织中11β-HSD1在干绒毛间质、绒毛、合体滋养层外层中广泛存在,11β-HSD2在绒毛合体滋养层细胞外层广泛存在,而对照组表达较少或不表达;胎盘11β-HSDs表达水平与妊娠期糖尿病有相关性(r=0.67、0.70,P=0.003、0.004)。结论:11β-HSDs表达水平与妊娠期糖尿病有一定关系。

Objective:To investigate the correlation between the expression of 11β-HSDs in placenta of pregnant women and their gestational diabetes mellitus(GDM)occurance.Methods:704 puerperae were divided into two groups according to the presence or absence of GDM from January 20 to April 2019.Among them,598 women without GDM were in control group,and 106 women with GDM were in study group.The expression levels of 11β-hydroxysteroid dehydrogenase(11β-HSDs)and the change of cortisol level of women in the two groups were detected,and the relationship between the expression of placental 11β-HSDs of women and their GDM occurance was analyzed.Results:The fasting insulin level,the insulin secretion index,and the maternal cortisol level of women in the study group were significant higher than those of women in the control group(P<0.05),but there were no significant difference in the cord blood cortisol level and neonatal body weight between the two groups(P>0.05).The positive rate of 11β-HSD1 in placenta tissue of women in the study group was 67.9%,which was significant higher than that(5.4%)of women in the control group.The results of immunohistochemistry showed that 11β-HSD1 was widely present in the outer layer of dry villus interstitial,villus and syncytiotrophoblasts of women in the study group,and 11β-HSD2 was also widely present in the outer layer of villus trophoblast cells,while which had little or no expression in placenta tissue of women in the control group.The expression level of placental 11β-HSDs was significantly correlated with GDM(r=0.67,0.70,P=0.003,0.004).Conclusion:The expression of 11β-HSDs in placental tissue of pregnant women has significantly correlation with their GDM occurrence.