肝X受体α(LXRα)及三磷酸腺苷结合盒转运体A1(ABCA1)参与子痫前期发病的机理研究

The mechanism of liver X receptorαand adenosine triphosphate binding cassette transporter A1 involved in the pathogenesis of preeclampsia

目的探讨在子痫前期发病中LXRα和ABCA1的变化及二者与脂质代谢异常的关系。方法选取2019年10月至2023年6月在福建医科大学附属泉州第一医院妇产科分娩的子痫前期孕妇112例(子痫前期组),根据妊娠34周前是否诊断为子痫前期,将其分为早发组和晚发组;同期住院生产的70名正常孕产妇为正常对照组(正常组),采用生化方法测得血清中血脂水平(TG、TC、LDL及HDL);采用ELISA法检测2组患者血清中的LXRα与ABCA1蛋白表达水平;采用免疫组化及半定量PCR(RT-PCR)检测正常组及子痫前期组胎盘组织中LXRα与ABCA1的表达。分析LXRα和ABCA1表达与血脂异常的关系。结果子痫前期组TG、TC、LDL高于正常组,HDL低于正常组,差异均具有统计学意义(均P<0.05)。RT-PCR及免疫组化显示子痫前期组胎盘和血清的LXRα、ABCA1表达低于正常组(P<0.05)。胎盘上LXRαmRNA水平与LXRα蛋白表达水平呈正相关,差异具有统计学意义(P<0.05);两组患者血清ABCA1的表达水平与其胎盘上ABCA1蛋白浓度呈正相关,与血液循环中LDL的浓度水平呈负相关,与血液循环中HDL的浓度水平呈正相关,差异均有统计学意义(均P<0.05)。结论子痫前期妇女的血脂水平及血清中LXRα、ABCA1表达异常,且与病情严重程度相关;LXRα及ABCA1参与了子痫前期的血脂代谢异常的发生,可以作为临床上评判相关病程进展的依据。

Objective To investigate the changes of LXRαand ABCA1 in preeclampsia and their relationship with abnormal lipid metabolism.Methods A total of 112 pregnant women who delivered in the Department of Obstetrics and Gynecology of Quanzhou First Hospital Affiliated to Fujian Medical University from October 2019 to June 2023 were selected(the preeclampsia group)and divided into early onset group,late onset group and normal control group according to whether they were diagnosed with preeclampsia before the 34th week of gestation;70 normal pregnant women hospitalized to give birth during the same period of time served as the normal control group(the normal group),and the levels of lipids in the serum were measured using biochemical methods(TG,TC,LDL and HDL);the expression of LXRαand ABCA1 protein levels in the serum of the 2 groups was detected by ELISA;and the expression of LXRαand ABCA1 in the placental tissues of the normal group and preeclampsia was detected by immunohistochemistry and semi-quantitative PCR(RT-PCR).The relationship between LXRαand ABCA1 expression and dyslipidemia was analyzed.Results TG,TC and LDL in preeclampsia group were higher than those in normal group,while HDL was lower,the difference was statistically significant(P<0.05).RT-PCR and immunohistochemistry showed that the expression of LXRαand ABCA1 in placenta and serum of preeclampsia group was lower than that of normal group,with statistical significance(P<0.05).There was a positive correlation between LXRαmRNA level and LXRαprotein expression level in placenta,and the difference was statistically significant(P<0.05).The expression level of serum ABCA1 was positively correlated with the concentration of ABCA1 protein in the placenta,negatively correlated with the concentration of LDL in blood circulation,and positively correlated with the concentration of HDL in blood circulation,with significant statistical significance(P<0.05).Conclusion The level of blood lipids and the expression of LXRαand ABCA1 in serum of preeclampsia women are abnormal and correlated to the severity of the disease.LXRαand ABCA1 are involved in the occurrence of lipid metabolism abnormalities in preeclampsia,which can be used as a basis for clinically judging the progression of the associated course of the disease.