| 陈鑫,肖琳,靳健美.妊娠糖尿病病人胎盘组织 IRS2和 IGFBP3表达对胰岛素抵抗及妊娠结局的影响[J].安徽医药,2025,29(3):575-579. |
| 妊娠糖尿病病人胎盘组织 IRS2和 IGFBP3表达对胰岛素抵抗及妊娠结局的影响 |
| Effects of insulin receptor substrate 2 and insulin-like growth factor binding protein 3 in placental tissue of gestational diabetes mellitus on insulin resistance and pregnancy outcome |
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| DOI：10.3969/j.issn.1009-6469.2025.03.028 |
| 中文关键词: 糖尿病，妊娠 胰岛素受体底物 2 胰岛素样生长因子结合蛋白 3 胰岛素抵抗 妊娠结局 |
| 英文关键词: Diabetes, gestational Insulin receptor substrate 2 Insulin-like growth factor binding protein 3 Insulin resistance Pregnancy outcome |
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| 中文摘要: |
| 目的探究妊娠糖尿病( GDM)病人胎盘组织中胰岛素受体底物 2(IRS2)和胰岛素样生长因子结合蛋白 3(IGFBP3)表达对胰岛素抵抗及妊娠结局的影响。方法选取达州市中西医结合医院 2021年 2月至 2022年 8月收治的 105例 GDM病人为 GDM组，并根据妊娠结局将 105例孕妇分为妊娠结局良好组( n=84)和妊娠结局不良组( n=21)。另选取同期于该院产检的 105例健康孕妇为对照组。实时荧光定量 PCR(RT-PCR)检测胎盘组织中 IRS2和 IGFBP3表达水平；全自动生化分析仪检测空腹血糖( FBG)、空腹胰岛素( FINS)。 Pearson法分析胎盘组织中 IRS2和 IGFBP3表达与 FBG、FINS、稳态模型胰岛素抵抗指数(HOMA-IR)的相关性；多因素 logistic回归分析法分析影响妊娠结局的因素。结果 GDM组孕妇胎盘组织中 IRS2 0.52±0.11和 IGFBP3表达水平 0.65±0.13低于对照组( 1.06±0.20、0.94±0.18)(均 P<0.001)GDM组孕妇 FBG(5.93±1.24)mmol/L、FINS(12.59±2.57)μU/L、HOMA-IR 3.32±0.64均明显高于对照组［( 4.26±0.81)mmol/L、(9.35±1.82)μU/L、1.77±0.43］(均 P<0.001)，GDM组孕妇早产、流产、产后出血等不良妊娠结局总发生率( 16.2%)高于对照组( 5.7%)(P<0.001)。 Pearson分析结果显示， GDM病人胎盘组织中 IRS2和 IGFBP3表达水平与 FBG、FINS、HOMA-IR均呈显著负相关( P<0.001)。与妊娠结局不良组比较［0.36±0.08、 |
| 英文摘要: |
| Objective To investigate the effects of insulin receptor substrate 2 (IRS2) and insulin-like growth factor binding protein 3(IGFBP3) expressions in placental tissue of gestational diabetes mellitus (GDM) patients on insulin resistance and pregnancy outcome.Methods A total of 105 GDM patients admitted to Dazhou Hospital of Integrated Traditional Chinese and Western Medicine fromFebruary 2021 to August 2022 were selected as GDM group and then assigned into good pregnancy outcome group (n=84) and bad preg-nancy outcome group (n=21) according to pregnancy outcome. Meanwhile, 105 healthy pregnant women who were examined in the samehospital during the same period were selected as the control group. Real-time fluorescence quantitative PCR (RT-PCR) was applied todetect the expressions of IRS2 and IGFBP3 in placenta; the fasting blood glucose (FBG) and fasting insulin (FINS) were measured byautomatic biochemical analyzer. Pearson method was applied to analyze the correlation between the expressions of IRS2 and IGFBP3 inplacenta and FBG, FINS, homeostatic model assessment of insulin resistance (HOMA-IR). The influencing factors of pregnancy out-come were analyzed by Logistic regression analysis.Results The expression levels of IRS2 (0.52±0.11) and IGFBP3 (0.65±0.13) inplacental tissue of pregnant women in GDM group were lower than those in control group (1.06±0.20, 0.94±0.18) (all P<0.001). FBG mmol/L, FINS and HOMA-IR in GDM group were significantly higher than those in control group [(5.93±1.24) mmol/L vs. (4.26±0.81) mmol/L, (12.59±2.57) μU/L vs. (9.35±1.82) μU/L, (3.32±0.64 vs. 1.77±0.43), respectively] (all P<0.001). The total incidence of pre‐term birth, abortion, postpartum hemorrhage and other adverse pregnancy outcomes in GDM group was higher than that in control group(16.2% vs. 5.7%; P<0.001). Pearson analysis results showed that the expression levels of IRS2 and IGFBP3 in placenta tissue of GDMpatients were obviously negatively correlated with FBG, FINS and HOMA-IR (all P<0.001). Compared with the poor pregnancy out-come group, the expression levels of IRS2 and IGFBP3 in placental tissue of pregnant women in good pregnancy outcome group weresignificantly higher [(0.56±0.14 vs. 0.36±0.08), (0.68±0.17 vs. 0.53±0.12), respectively], while FBG, FINS and HOMA-IR were signifi-cantly lower [(5.68±1.19) mmol/L vs. (6.72±1.44) mmol/L, (12.25±2.44) μU/L vs. (13.97±3.11) μU/L, (3.09±0.57 vs. 4.17±0.86)] (all P<0.05). Multivariate Logistic regression analysis results showed that IRS2, IGFBP3 and HOMA-IR were all influencing factors of preg-nancy outcome (OR=0.92, 0.92, 1.30, all P<0.05).Conclusion The expressions of IRS2 and IGFBP3 are low in the placenta of GDM |
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