目的:研究胰岛素降解酶(IDE)基因rs11187007位点多态性与妊娠期糖尿病(GDM)患者胰岛素抵抗、全身炎症反应的相关性。方法:选择我院确诊的GDM孕妇作为GDM组、同期产检并分娩的健康孕妇作为对照组。采集外周血并测定IDE基因rs11187007位点的基因型及细胞因子IL-6、IL-10、TNF-α、Chemerin、Omentin-1的含量,采集胎盘并测定IRS-1、IRS-2、GLUT3、GLUT4的表达量。结果:GDM组孕妇外周血中IDE基因rs11187007位点AA基因型的构成比、IL-10及Omentin-1的含量以及胎盘中IRS-1、IRS-2、GLUT3、GLUT4的mRNA表达量均低于对照组,外周血中IDE基因rs11187007位点AG基因型、GG基因型的构成比以及IL-6、TNF-α、Chemerin的含量高于对照组；AG基因型、GG基因型的GDM胎盘中IRS-1、IRS-2、GLUT3、GLUT4的mRNA表达量以及外周血中IL-10、Omentin-1的含量低于AA基因型的GDM胎盘,外周血中IL-6、TNF-α、Chemerin的含量高于AA基因型的GDM孕妇。结论:GDM患者体内IDE基因rs11187007位点等位基因A向G的突变能够加重胰岛素抵抗及全身炎症反应。

Objective: To study the correlation of insulin-degrading enzyme (IDE) gene rs11187007 locus polymorphism with insulin resistance and systemic inflammatory response in patients with gestational diabetes mellitus (GDM). Methods: The pregnant women diagnosed with GDM in our hospital between March 2015 and January 2018 were selected as the GDM group, and healthy pregnant women who had prenatal examination and gave birth during the same period were selected as the control group. Peripheral blood was collected to measure the genotype of IDE gene rs11187007 locus as well as the contents of cytokines IL-6, IL-10, TNF-α, Chemerin and Omentin-1, and placenta was collected to measure the expression levels of IRS-1, IRS-2, GLUT3 and GLUT4. Results: The constituent ratio of IDE gene rs11187007 locus AA genotype, IL-10 and Omentin-1 contents in peripheral blood as well as IRS-1, IRS-2, GLUT3 and GLUT4 mRNA expression levels in placenta of GDM group were all lower than those of control group whereas the constituent ratio of IDE gene rs11187007 locus AG genotype and GG genotype as well as IL-6, TNF-α and Chemerin contents in peripheral blood were higher than those of control group; IRS-1, IRS-2, GLUT3 and GLUT4 mRNA expression levels in the GDM placenta with AG genotype and GG genotype as well as IL-10 and Omentin-1 contents in the peripheral blood were lower than those in the GDM placenta with AA genotype whereas IL-6, TNF-α and Chemerin contents in the peripheral blood were higher than those in the GDM placenta with AA genotype. Conclusion: The mutation from IDE gene rs11187007 allele A to G in GDM patients can aggravate the insulin resistance and systemic inflammatory response.

R714.256

四川省卫生计生委科技项目(17PJ380)