妊娠期糖尿病患者孕期铁代谢水平与IRS-2基因单核苷酸多态性的关系

Relationship between serum iron metabolism and single nucleotide polymorphism of IRS-2 gene in pregnant women with gestational diabetes mellitus

目的:探讨妊娠期糖尿病(GDM)患者IRS-2基因的单核苷酸多态性(SNP)与血清铁代谢水平之间的关系。方法:选取2018年1月至2023年3月在温州市中心医院接受治疗的50例GDM患者作为观察组,50例正常孕妇作为对照组。2组均在孕期12周进行首次产前检查,GDM组在孕期24~28周被确诊。检测空腹血糖、胰岛素、C肽、血清铁、转铁蛋白、转铁蛋白各项指标及IRS-2基因序列。结果:GDM组的糖代谢指标(空腹血糖、胰岛素、C肽、胰岛素抵抗指数)及铁代谢指标(血清铁、转铁蛋白)均明显高于正常孕妇组(P<0.05)。在IRS-2基因1057位点,两组共检出3种遗传型,包括纯合野生(GG)、杂合子(GD)和纯合突变体(DD)。相比于GG遗传型个体,GD遗传型(OR=4.19,95%CI=1.63~10.76,P=0.003)与DD遗传型(OR=10.67,95%CI=2.96~38.40,P<0.001)个体的GDM患病风险均显著增高。同时,GD和DD个体的铁代谢水平明显高于GG个体(P<0.05)。结论:妊娠期人群中,IRS-2基因1057位点的SNP与GDM的发生及血清铁代谢异常蓄积具有显著相关性。

Objective:To explore the relationship between single nucleotide polymorphism of IRS-2 gene and serum iron metabolism level in patients with gestational diabetes mellitus(GDM).Methods:50 GDM patients admitted to Wenzhou Central Hospital from January 2018 to March 2023 were selected in the observation group,and 50 normal pregnant women were selected in the control group.All of them had their first prenatal examination at 12 weeks of gestation,and the GDM group was diagnosed at 24-28 weeks.Weight,glucose metabolism indicators and iron metabolism indicators were measured in both groups,and single nucleotide polymorphism sequencing of the 1057 site of the IRS-2 gene was performed and its potential relationship with GDM explained.Results:The glucose metabolism and iron metabolism related indicators of the GDM group were significantly higher than those of the normal pregnant women group(P<0.01).Three genotypes were detected at the 1057 site of the IRS-2 gene in both groups,including pure wild(GG),heterozygous(GD),and pure mutant(DD).Compared with the individuals with GG genotype,the GDM risk of individuals with GD(OR=4.19,95%CI=1.63-10.76,P=0.003)and DD genotypes(OR=10.67,95%CI=2.96-38.40,P<0.001)were significantly increased.Meanwhile,individuals with GD and DD genotypes exhibited significantly higher iron metabolism levels compared with those with the GG genotype(P<0.05).Conclusion:In pregnant women,the nucleotide polymorphism in 1057 site of IRS-2 gene is significantly correlated with the occurrence of GDM and abnormal accumulation of serum iron metabolism.