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目的:探讨妊娠糖尿病(GDM)纤溶酶原激活物抑制因子-1(PAI-1)基因启动子区4G/5G多态性的分布特点及其与新生儿出生体重的关系。方法:研究对象为汉族GDM(GDM组)和正常孕妇(对照组)各60例,测量其血压、身高和孕前体重及其新生儿出生体重;采集血样标本,用PCR-RFLP方法测定PAI-1基因启动子区4G/5G位点多态分布,用发色底物法检测血浆PAI-1活性。结果:GDM组孕前体重指数(BMI)、血浆PAI-1活性和新生儿出生体重显著高于对照组(P<0.01)。2组孕妇PAI-1基因4G/5G多态性分布差异有统计学意义(P<0.01),GDM组4G/4G基因型和4G等位基因频率高于对照组。3种不同基因型孕妇的血浆PAI-1的活性和孕前BMI的差异均有统计学意义(P<0.01),4G/4G基因型者血浆PAI-1的活性和孕前BMI显著高于4G/5G和5G/5G基因型。巨大儿发生率在两组孕妇间的差异无统计学意义,但4G/4G基因型孕妇的新生儿出生体重显著高于4G/5G和5G/5G基因型孕妇的新生儿(P<0.01)。结论:GDM组PAI-1基因启动子区4G/4G基因型频率增高,该基因型可能是广西南宁地区汉族人群GDM的易感基因;与PAI-1基因启动子区4G/4G多态性相关的GDM对新生儿出生体重有重要影响。
Objective: To investigate the distribution of 4G / 5G polymorphism in the promoter region of gestational diabetes mellitus (PAI-1) gene and its relationship with newborn birth weight. Methods: Sixty male subjects with GDM (GDM group) and normal pregnant women (control group) were included in this study. Blood pressure, height, body weight before pregnancy and birth weight were measured. Blood samples were taken and PAI-1 was measured by PCR-RFLP The 4G / 5G locus of the gene promoter was polymorphic, and PAI-1 activity in plasma was detected by the chromogenic substrate method. Results: The body mass index (BMI), plasma PAI-1 activity and newborn birth weight in GDM group were significantly higher than those in control group (P <0.01). The distribution of 4G / 5G polymorphism of PAI-1 gene in two groups of pregnant women was significantly different (P <0.01). The frequency of 4G / 4G genotype and 4G allele in GDM group was higher than that in control group. Plasma PAI-1 activity and pre-pregnancy BMI were significantly different among 3 genotypes of pregnant women (P <0.01). The plasma PAI-1 activity and pre-pregnancy BMI of 4G / 4G genotype were significantly higher than that of 4G / 5G And 5G / 5G genotypes. The prevalence of macrosomia was not significantly different between the two groups of pregnant women, but the neonatal birth weight of pregnant women with 4G / 4G genotype was significantly higher than that of pregnant women with 4G / 5G and 5G / 5G genotypes (P <0.01). Conclusion: The frequency of 4G / 4G genotype of PAI-1 gene promoter region in GDM group is increased, which may be the susceptible gene of GDM in Han population in Nanning, Guangxi. The genotypes of 4G / 4G are associated with 4G / 4G polymorphism of PAI-1 gene promoter region GDM has a significant impact on newborn birth weight.