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目的:通过检测胰岛素受体底物-1(insulin receptor substrate-1,IRS-1)、胰岛素受体底物-2(insulin receptor substrate-2,IRS-2)及磷脂酰肌醇-3(phospllatidylinositol 3-kinase,PI-3K)在妊娠期糖尿病(gestational diabetes mellitus,GDM)及糖耐量正常(normal glucose,NG)孕妇大网膜脂肪组织的表达,以期探讨GDM孕妇胰岛素受体底物IRS-1/-2及PI-3K表达变化对胰岛素抵抗的影响。方法:将研究对象分为两组:GDM组26例、NG组24例。研究对象在足月入院待产后测量各研究对象产前体重、空腹血糖、空腹胰岛素等临床指标,因产科指征行剖宫产分娩时收集大网膜组织5g,实时荧光定量PCR检测网膜组织中IRS-1/-2、PI-3K mRNA表达,免疫印迹法检测蛋白质的表达。结果:①GDM组表现出明显的胰岛素抵抗;②IRS-1及PI-3K在GDM孕妇网膜组织中mRNA及蛋白质的表达明显降低,而IRS-2在GDM孕妇网膜组织中的表达与NG组无明显差异;③Perason相关性分析显示,IRS-1与IRS-2在大网膜的表达呈正相关;④随BMI增加,GDM孕妇大网膜脂肪组织中IRS-1 mRNA表达逐渐降低,PI-3K的表达始终处于较低表达状态。而在NG组孕妇,BMI增加IRS-1及PI-3K mRNA表达逐渐增加,但当BMI≥29 kg/m2时IRS-1及P85的表达亦开始下降,IRS-2 mRNA表达在GDM IRS-1较低水平时表达稍有增高。结论 :GDM孕妇大网膜脂肪组织中IRS-1/PI-3K信号通路的异常参与了胰岛素抵抗的发生。
OBJECTIVE: To detect the expression of insulin receptor substrate-1 (IRS-1), insulin receptor substrate-2 (IRS-2) and phosphatidylinositol 3-kinase, PI-3K) in gestational diabetes mellitus (GDM) and normal glucose (NG) pregnant women, in order to investigate the insulin receptor substrate IRS-1 / -2 and PI-3K expression changes on insulin resistance. Methods: The subjects were divided into two groups: 26 cases in GDM group and 24 cases in NG group. Subjects were enrolled in full-term postpartum hospital to measure postpartum birth weight, fasting blood glucose, fasting insulin and other clinical indicators of obstetrical indications for cesarean delivery of omentum collected 5g, real-time quantitative PCR detection of omentum IRS-1 / -2, PI-3K mRNA expression were detected by Western blotting. Results: ①GDM group showed obvious insulin resistance; ②IRS-1 and PI-3K mRNA and protein expression in omentum of GDM pregnant women were significantly decreased, while the expression of IRS-2 in omentum of GDM pregnant women was significantly lower than that in NG group (3) Perason correlation analysis showed that the expression of IRS-1 and IRS-2 in omentum was positively correlated; (4) With the increase of BMI, the expression of IRS-1 mRNA in omental adipose tissue of GDM pregnant women decreased gradually; Expression is always in a lower expression state. In NG group, the expression of IRS-1 and PI-3K increased gradually with the increase of BMI, but the expression of IRS-1 and P85 began to decline when BMI was higher than 29 kg / m2. The expression of IRS-2 mRNA in GDM IRS-1 The expression is slightly higher at lower levels. Conclusion: The abnormal IRS-1 / PI-3K signaling pathway in omental adipose tissue of pregnant women with GDM is involved in the development of insulin resistance.