胎盘及脂肪组织中HMGB1表达与胰岛素抵抗程度及产后糖代谢异常的相关性研究

Research on correlation of HMGB1 expression in placenta and adipose tissue with insulin resistance and abnormal postpartum glucose metabolism

目的 研究妊娠期糖尿病(gestational diabetes mellitus, GDM)患者胎盘及脂肪组织中高迁移率族蛋白B1(high mobility group box 1,HMGB1)表达与胰岛素抵抗程度及产后糖代谢异常的相关性。方法 选择2018年1月至2020年3月在海安市中医院诊断为GDM并接受剖宫产的58例患者作为GDM组,同期在我院产检并接受剖宫产的60例健康孕妇作为对照组。剖宫产当天取血清并检测HMGB1、空腹血糖(fasting blood glucose, FBG)、空腹胰岛素(fasting insulin, FINS)的含量,计算胰岛素抵抗指数(homeostasis model assessment insulin resistance, HOMA-IR);剖宫产术中取脂肪组织、术后取胎盘组织,检测HMGB1的表达水平;剖宫产术后6~8周行口服葡萄糖耐量试验,判断是否发生糖代谢异常。结果 GDM组血清中HMGB1及FINS的含量、HOMA-IR水平、胎盘及脂肪组织中HMGB1的表达水平均高于对照组(P<0.05);GDM组胎盘及脂肪组织中HMGB1的表达水平与血清HMGB1及FINS的含量、HOMA-IR水平具有正相关关系;GDM组中产后糖代谢异常患者的血清HMGB1含量、胎盘及脂肪组织中HMGB1的表达水平均高于产后糖代谢正常患者(P<0.05)。结论 GDM患者胎盘及脂肪组织中HMGB1高表达与母体血液循环中HMGB1增多、胰岛素抵抗加重及产后糖代谢异常有关。

Objective To study the correlation between the expression of high mobility group box 1(HMGB1) in placenta and adipose tissue of patients with gestational diabetes mellitus(GDM) and the degree of insulin resistance and abnormal postpartum glucose metabolism.Methods A total of 58 patients who were diagnosed with GDM and underwent cesarean section in Hai’an Hospital of Traditional Chinese Medicine from January 2018 to March 2020 were selected as the GDM group, and 60 healthy pregnant women who received cesarean section in our hospital during the same period were selected as the control group.Serum was collected on the day of cesarean section, and the contents of HMGB1,fasting blood glucose(FBG),and fasting insulin(FINS) were detected, and homeostasis model assessment insulin resistance(HOMA-IR) was calculated;Adipose tissue was collected during hysterectomy and placental tissue after operation to detect the expression level of HMGB1;oral glucose tolerance test was performed 6 to 8 weeks after cesarean section to determine whether abnormal glucose metabolism occurred.Results The serum levels of HMGB1 and FINS,HOMA-IR levels, and the expression levels of HMGB1 in placenta and adipose tissue in the GDM group were higher than those in the control group(P<0.05).Serum HMGB1,FINS and HOMA-IR levels were positively correlated;serum HMGB1 levels and HMGB1 expression levels in placenta and adipose tissue in postpartum patients with abnormal glucose metabolism in GDM group were higher than those in postpartum patients with normal glucose metabolism(P<0.05).Conclusion The high expression of HMGB1 in placenta and adipose tissue of GDM patients is related to the increase of HMGB1 in maternal blood circulation, aggravation of insulin resistance and abnormal postpartum glucose metabolism.