半乳糖凝集素3在妊娠期糖尿病孕妇中表达及与胰岛素抵抗关系
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摘要
目的:探讨半乳糖凝集素3(Galectin-3)在妊娠期糖尿病(GDM)孕妇外周血以及胎盘组织中的表达特点,分析其与胰岛素抵抗关系。方法:收集2016年2月—2017年12月本院定期产检的116例孕妇为研究对象,依据GDM诊断标准将孕妇分为GDM组(56例),非GDM组(60例),采用稳态效应模型计算胰岛素抵抗指数(HOMA-IR),将GDM组分为胰岛素抵抗组(HOMA-IR≥1.66)(30例)、非胰岛素抵抗组(HOMA-IR<1.66)(26例),分析各组血清Galectin-3水平,采用荧光定量PCR技术、蛋白免疫印迹法检测产妇胎盘Galectin-3mRNA、蛋白表达并分析与血清Galectin-3、HOMA-IR的相关性。结果:血清Galectin-3水平GDM组(32.01±6.17)ng/ml高于非GDM组(8.01±2.05ng/ml),胰岛素抵抗组(42.17±7.85)高于非胰岛素抵抗组(28.14±5.37ng/ml)(均P<0.05)。胎盘组织Galectin-3mRNA表达GDM组(0.71±0.67)高于非GDM组(0.41±0.25),胰岛素抵抗组(0.97±0.85)高于非胰岛素抵抗组(0.54±0.37);Galectin-3蛋白表达水平GDM组(0.81±0.17)高于非GDM组(0.41±0.05),胰岛素抵抗组(1.07±0.83)高于非胰岛素抵抗组(0.64±0.27)(均P<0.05)。Galectin-3mRNA、蛋白表达、血清Galectin-3与HOMA-IR呈正相关(r=0.437、0.357、0.309,P<0.05),Galectin-3mRNA、蛋白表达与血清Galectin-3无关(r=0.019、0.025,P>0.05)。结论:GDM孕产妇血清Galectin-3水平、胎盘组织Galectin-3mRNA、蛋白表达均明显增高,提示GDM有胰岛素抵抗的可能,Galectin-3可作为GDM诊断和治疗的有效指标。
Objective:To explore the expression of Galectin-3in peripheral blood and placenta tissue of pregnant women with gestational diabetes mellitus(GDM),and to analyze its relationship with insulin resistance.Methods:116pregnant women who underwent regular pregnancy check in Yiling district maternal and child health care hospital from February 2016 to December 2017 were included in the study.According to the GDM diagnostic criteria,all included pregnant women were divided into GDM group(56cases)and non-GDM group(60cases).And pregnant women in GDM group were also divided into insulin resistance group(HOMA-IR≥1.66,30cases)and non-insulin resistance group(HOMA-IR<1.66,26cases).The insulin resistance index(HOMA-IR)was calculated by the steady-state effect model.The levels of plasma Galectin-3of pregnant women in each group were analyzed.The expression of Galectin-3mRNA and protein in maternal placenta was detected by real-time PCR and Western blotting.And the correlation between protein expression and serum Galectin-3level or HOMA-IR were analyzed.Results:The serum Galectin-3level of pregnant women in GDM group was(32.01±6.17)ng/ml,which was significant higher than that[(8.01±2.05)ng/ml]of pregnant women in non-GDM group(P<0.05).The serum Galectin-3level of pregnant women in insulin resistant group was(42.17±7.85)ng/ml,which was significant higher than that[(28.14±5.37)ng/ml]of pregnant women in non-insulin resistance group(P<0.05).The expression of Galectin-3 mRNA in placenta of pregnant women in GDM group was 0.71±0.67,which was significant higher than that(0.41±0.25)of pregnant women in non-GDM group(P<0.05).The expression of Galectin-3mRNA in placenta of pregnant women in insulin resistance group was0.97±0.85,which was significant higher than that(0.54±0.37)of pregnant women in non-insulin resistant group(P<0.05).The expression level of Galectin-3protein of pregnant women in GDM group was 0.81±0.17,which was significant higher than that(0.41±0.05)of pregnant women in non-GDM group(P<0.05).The expression of Galectin-3protein in placental tissues of pregnant women in insulin resistance group was 1.07±0.83,which was significant higher than that(0.64±0.27)of pregnant women in non-insulin resistant group(P<0.05).There were positively correlation between Galectin-3mRNA,protein expression,or serum Galectin-3and HOMA-IR(r=0.437,0.357,0.309,P<0.05),but there were no correlation between Galectin-3mRNA or protein expression and serum Galectin-3level(r=0.019,0.025,P>0.05).Conclusion:The serum level of Galectin-3and Galectin-3mRNA in placental,and the protein expression in placental tissues of pregnant women are significantly increased,which means the pregnant women with GDM have possible insulin resistance.So Galectin-3level can be used as an effective indicator for diagnosing and treating pregnant women with GDM.
Objective:To explore the expression of Galectin-3in peripheral blood and placenta tissue of pregnant women with gestational diabetes mellitus(GDM),and to analyze its relationship with insulin resistance.Methods:116pregnant women who underwent regular pregnancy check in Yiling district maternal and child health care hospital from February 2016 to December 2017 were included in the study.According to the GDM diagnostic criteria,all included pregnant women were divided into GDM group(56cases)and non-GDM group(60cases).And pregnant women in GDM group were also divided into insulin resistance group(HOMA-IR≥1.66,30cases)and non-insulin resistance group(HOMA-IR<1.66,26cases).The insulin resistance index(HOMA-IR)was calculated by the steady-state effect model.The levels of plasma Galectin-3of pregnant women in each group were analyzed.The expression of Galectin-3mRNA and protein in maternal placenta was detected by real-time PCR and Western blotting.And the correlation between protein expression and serum Galectin-3level or HOMA-IR were analyzed.Results:The serum Galectin-3level of pregnant women in GDM group was(32.01±6.17)ng/ml,which was significant higher than that[(8.01±2.05)ng/ml]of pregnant women in non-GDM group(P<0.05).The serum Galectin-3level of pregnant women in insulin resistant group was(42.17±7.85)ng/ml,which was significant higher than that[(28.14±5.37)ng/ml]of pregnant women in non-insulin resistance group(P<0.05).The expression of Galectin-3 mRNA in placenta of pregnant women in GDM group was 0.71±0.67,which was significant higher than that(0.41±0.25)of pregnant women in non-GDM group(P<0.05).The expression of Galectin-3mRNA in placenta of pregnant women in insulin resistance group was0.97±0.85,which was significant higher than that(0.54±0.37)of pregnant women in non-insulin resistant group(P<0.05).The expression level of Galectin-3protein of pregnant women in GDM group was 0.81±0.17,which was significant higher than that(0.41±0.05)of pregnant women in non-GDM group(P<0.05).The expression of Galectin-3protein in placental tissues of pregnant women in insulin resistance group was 1.07±0.83,which was significant higher than that(0.64±0.27)of pregnant women in non-insulin resistant group(P<0.05).There were positively correlation between Galectin-3mRNA,protein expression,or serum Galectin-3and HOMA-IR(r=0.437,0.357,0.309,P<0.05),but there were no correlation between Galectin-3mRNA or protein expression and serum Galectin-3level(r=0.019,0.025,P>0.05).Conclusion:The serum level of Galectin-3and Galectin-3mRNA in placental,and the protein expression in placental tissues of pregnant women are significantly increased,which means the pregnant women with GDM have possible insulin resistance.So Galectin-3level can be used as an effective indicator for diagnosing and treating pregnant women with GDM.
引文
[1]张跃先,刘云,任利容.381例妊娠期糖尿病血糖管理与母婴妊娠结局的临床分析[J].中国优生与遗传杂志,2010,18(9):59-60,21.
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[3]王萍,王宇朋,马清,等.Galectin-3与糖尿病性心血管病的关系[J].临床和实验医学杂志,2016,15(23):2383-2385.
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[5]Li P,Liu S,Lu M,,et al.Hematopoietic-derived galectin-3causes cellular and systemic insulin resistance[J].Cell 2016;167(4):973-84.
[6]中华医学会妇产科分会产科学组,中华医学会围产医学分会妊娠合并糖尿病协作组[J].妊娠合并糖尿病临床诊断与治疗推荐指南(草案),中华妇产科杂志,2007,42:426-428.
[7]谢梦,周毓青,林金芳.多囊卵巢综合征卵巢超声影像学特征及其与内分泌代谢异常的相关性分析[J].中国实用妇科与产科杂志,2008,24(9):673-676.
[8]Shen J,Kondal D,Rubinstein A,et al.A multiethnic study fo pre-diabetes and diabetes in LMIC[J].Glob Heart,2016,11:61-70.
[9]Haffner S,Taegtmeyer H.Epidemic obesity and the metabolic syndrome[J].Circulation 2003;108(13):1541-1545.
[10]Olefsky JM,Glass CK.Macrophages,infl ammation,and insulin resistance[J].Annu Rev Physiol 2010;72:219-246.
[11]Lumeng CN,Bodzin JL,Saltiel AR.Obesity induces a phenotypic switch in adipose tissue macrophage polarization[J].JClin Invest 2007;117(1):175-184.
[12]Hotamisligil GS,Shargill NS,Spiegelman BM.Adipose expression of tumor necrosis factor-alpha:Direct role in obesity-linked insulin resistance[J].Science 1993;259(5091):87-91.
[13]Yang RY,Rabinovich GA,Liu FT.Galectins:Structure,function and therapeutic potential[J].Expert Rev Mol Med2008;10:e17.
[14]侯少聪,李平平.半乳糖苷凝集素Galectin3直接诱发胰岛素抵抗[J].中国细胞生物学学报,2017,39(5):537-541.
[15]Sano H,Hsu DK,Yu L,et al.Human galectin-3is a novel chemoattractant for monocytes and macrophages[J].J Immunol 2000;165(4):2156-2164.
[2]解梅琳,刘爱红.妊娠期糖尿病发病机制[J].中国医师进修杂志,2011,34(2):152-153.
[3]王萍,王宇朋,马清,等.Galectin-3与糖尿病性心血管病的关系[J].临床和实验医学杂志,2016,15(23):2383-2385.
[4]杨永青,赵梅,段江燕.半乳糖苷凝集素-3与肥胖及2型糖尿病[J].中国生物化学与分子生物学报,2017,33(12):1203-1208.
[5]Li P,Liu S,Lu M,,et al.Hematopoietic-derived galectin-3causes cellular and systemic insulin resistance[J].Cell 2016;167(4):973-84.
[6]中华医学会妇产科分会产科学组,中华医学会围产医学分会妊娠合并糖尿病协作组[J].妊娠合并糖尿病临床诊断与治疗推荐指南(草案),中华妇产科杂志,2007,42:426-428.
[7]谢梦,周毓青,林金芳.多囊卵巢综合征卵巢超声影像学特征及其与内分泌代谢异常的相关性分析[J].中国实用妇科与产科杂志,2008,24(9):673-676.
[8]Shen J,Kondal D,Rubinstein A,et al.A multiethnic study fo pre-diabetes and diabetes in LMIC[J].Glob Heart,2016,11:61-70.
[9]Haffner S,Taegtmeyer H.Epidemic obesity and the metabolic syndrome[J].Circulation 2003;108(13):1541-1545.
[10]Olefsky JM,Glass CK.Macrophages,infl ammation,and insulin resistance[J].Annu Rev Physiol 2010;72:219-246.
[11]Lumeng CN,Bodzin JL,Saltiel AR.Obesity induces a phenotypic switch in adipose tissue macrophage polarization[J].JClin Invest 2007;117(1):175-184.
[12]Hotamisligil GS,Shargill NS,Spiegelman BM.Adipose expression of tumor necrosis factor-alpha:Direct role in obesity-linked insulin resistance[J].Science 1993;259(5091):87-91.
[13]Yang RY,Rabinovich GA,Liu FT.Galectins:Structure,function and therapeutic potential[J].Expert Rev Mol Med2008;10:e17.
[14]侯少聪,李平平.半乳糖苷凝集素Galectin3直接诱发胰岛素抵抗[J].中国细胞生物学学报,2017,39(5):537-541.
[15]Sano H,Hsu DK,Yu L,et al.Human galectin-3is a novel chemoattractant for monocytes and macrophages[J].J Immunol 2000;165(4):2156-2164.