HBV感染对妊娠期糖尿病孕妇肝功能及NF-κB信号通路的影响

Influence of HBV infection on liver function and NF-κB signaling pathway of pregnant women with gestational diabetes mellitus

目的探究乙型肝炎病毒(HBV)感染对妊娠期糖尿病孕妇肝功能及核因子(NF)-κB信号通路的影响。方法随机选取2017年1月-2020年12月于胜利油田中心医院建档并进行产检的妊娠期糖尿病合并HBV感染孕妇100例为研究组、单纯妊娠糖尿病孕妇100例为对照组。检测入组孕妇血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)和糖化血红蛋白(HbAlc)]、肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸转氨酶(ALT)、总胆汁酸(TBA)和总胆红素(TBIL)]、炎症因子[白细胞介素(IL)-6、-1β、肿瘤坏死因子α(TNF-α)]及外周血单核细胞中NF-κB、抑制因子(I)κB mRNA及蛋白表达,比较两组不良妊娠结局及并发症。结果研究组FPG、2hPG、HbAlc、AST、ALT、TBA、TBIL、IL-6、IL-1β、TNF-α、NF-κB mRNA及p-NF-κB/NF-κB水平均高于对照组,IκB mRNA和p-IκB/IκB水平均低于对照组(P<0.05);研究组胎儿宫内窘迫、妊娠肝内胆汁淤积症发生率高于对照组(P<0.05),但两组早产、巨大儿、流产、产后出血、新生儿窒息、低出生体质量儿及妊娠高血压发生率的比较,差异无统计学意义。结论HBV感染可加重妊娠期糖尿病孕妇糖代谢紊乱、肝功能损伤和炎症因子分泌异常,可能与活化NF-κB信号通路有关。

OBJECTIVE To explore the influence of hepatitis B virus(HBV)infection on liver function and nuclear factor(NF)-κB signaling pathway of pregnant women with gestational diabetes mellitus.METHODS A total of 100 gestational diabetes mellitus pregnant women complicated with HBV infection who were established files and received prenatal examination in Shengli Oilfield Central Hospital from Jan 2017 to Dec 2020 were randomly chosen as the study group,100 pregnant women who had simple gestational diabetes mellitus were chosen as the control group.The blood glucose indexes[fasting blood glucose(FPG),2h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],liver function indexes[aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bile acid(TBA),total bilirubin(TBIL)],inflammatory factors[interleukin(IL)-6,IL-1β,tumor necrosis factor-α(TNF-α)]and expression levels of NF-κB and inhibitor(I)κB mRNA and proteins in peripheral blood mononuclear cells were detected for the two groups of pregnant women.The adverse pregnancy outcomes and complications were observed and compared between the two groups.RESULTS The levels of FPG,2hPG,HbAlc,AST,ALT,TBA,TBIL,IL-6,IL-1β,TNF-α,NF-κB mRNA and p-NF-κB/NF-κB of the study group were higher than those of the control group,while the levels of IκB mRNA and p-IκB/IκB of the study group were lower than those of the control group(P<0.05).The incidence rates of fetal intrauterine distress and gestational intrahepatic cholestasis were higher in the study group than in the control group(P<0.05),however,there were no significant differences in the incidence rates of premature delivery,fetal macrosomia,abortion,postpartum hemorrhage,neonatal asphyxia,low birth weight and gestational hypertension between the two groups.CONCLUSION The HBV infection may aggravate the disturbance of carbohydrate metabolism,liver function damage and abnormal secretions of inflammatory factors of the GDM women,which may be associated with the activated NF-κB signaling pathway.