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目的本研究测定妊娠期糖尿病(GDM)与正常妊娠妇女,胎盘组织中蛋白酪氨酸磷酸酶1B(PTP 1B)的表达差异,研究PTP 1B表达与胰岛素抵抗的关系,探讨其在GDM患者发病中的可能机制。方法将研究组分为2组,GDM组50例,对照组50例,采用免疫组织化学方法(IHC)检测其胎盘组织中PTP 1B的表达;生化指标:检测空腹血糖(FBG)、空腹胰岛素(FINS)、采用胰岛素稳态模型评估法(HOMA)计算胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能(HOMA-β%)、胰岛素敏感指数(HOMA-ISI);并统计分析相关资料。结果 (1)两组孕妇年龄、孕周、孕产次进行比较,差异均无统计学意义(P>0.05)。(2)GDM组患者FBG,FINS均高于正常对照组、差异有统计学意义(P<0.01);GDM组HOMA-IR明显高于对照组,差异有统计学意义(P<0.01);HOMA-ISI和HOMA-β均低于对照组,差异有统计学意义(P<0.01)。(3)GDM组胎盘组织中,PTP 1B阳性表达率为91.83%(46/49);正常妊娠对照组:阳性表达率仅56%(28/50)。两组相比,GDM组阳性表达高于对照组,差异具有统计学意义(χ2=19.45,P<0.01)。(4)GDM组PTP 1B表达增强与HOMA-IR呈正相关,相关系数(r=0.563 P=0.000)。结论 GDM组PTP 1B水平明显升高,其含量与HOMA-IR呈正相关,提示GDM患者存在严重的胰岛素抵抗。在正常妊娠生理过中,PTP 1B在胎盘组织合体滋养层细胞中不表达或弱表达,而GDM妊娠胎盘组织合体滋养层细胞中PTP-1B的表达增强,可能使得胰岛素信号转导系统受体后通路受损,从而发生胰岛素抵抗及GDM。PTP-1B的表达增强可能是其重要因素。
Objective To investigate the relationship between the expression of PTP 1B and insulin resistance in gestational diabetes mellitus (GDM) and normal pregnant women and placenta tissues, and to explore the role of PTP 1B in the pathogenesis of GDM Possible mechanism. Methods The study groups were divided into two groups: 50 cases in GDM group and 50 cases in control group. The expression of PTP 1B in placenta was detected by immunohistochemical method (IHC). The biochemical indexes were detected by fasting blood glucose (FBG), fasting insulin FINS). HOMA-IR, HOMA-β% and HOMA-ISI were calculated by insulin homeostasis model assessment (HOMA). The related data were analyzed statistically. Results (1) There was no significant difference in the age, gestational age and gestational age between the two groups (P> 0.05). (2) FBG and FINS in GDM group were significantly higher than those in normal control group (P <0.01); HOMA-IR in GDM group was significantly higher than that in control group (P <0.01); HOMA -ISI and HOMA-β were lower than the control group, the difference was statistically significant (P <0.01). (3) In placenta of GDM group, the positive rate of PTP 1B expression was 91.83% (46/49). In normal pregnancy control group, the positive rate of PTP 1B expression was only 56% (28/50). The positive expression of GDM group was higher than that of the control group, the difference was statistically significant (χ2 = 19.45, P <0.01). (4) There was a positive correlation between PTP 1B expression and HOMA-IR in GDM group, and the correlation coefficient (r = 0.563 P = 0.000). Conclusion The level of PTP 1B in GDM group is significantly higher than that in HOMA-IR group, suggesting that there is a serious insulin resistance in GDM patients. In normal pregnancy physiology, PTP 1B is not expressed or weakly expressed in placental syncytiotrophoblast cells, while PTP-1B expression is increased in syncytiotrophoblast cells of GDM placenta, which may make insulin signaling transduction system receptor Pathway impaired, resulting in insulin resistance and GDM. The increased expression of PTP-1B may be an important factor.