Yanagisawa K, Iwasaki N, Sanaka M, Minei S, Kanamori M, Omori Y, Iwamoto Y
Diabetes Center, Tokyo Women's Medical University, Japan.
Diabetes Res Clin Pract. 1999 Apr;44(1):41-7. doi: 10.1016/s0168-8227(99)00022-4.
Inappropriate body weight gain during pregnancy has critical effects on the outcome for both mother and fetus. Therefore, body weight gain is an important issue in the management of pregnancy in women with diabetes. A Trp64Arg substitution in the beta3-AR gene has been reported to be associated with body weight gain and obesity in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The aim of this study was to elucidate the contribution of the beta3-AR gene to body weight gain during pregnancy in subjects with diabetes. We analyzed 199 diabetic patients (NIDDM/IDDM; 131/68) and patient data was obtained from the first delivery of each individual. The mean age at diagnosis of diabetes was 22.9 +/- 7.5 years (mean +/- S.D.) and the mean age at delivery was 29.8 +/- 4.5 years. A polymorphism of the beta3-AR gene was detected by PCR-RFLP using Bst OI, which recognizes a Trp64Arg substitution. The frequency of the Trp64Arg allele was 0.15 in NIDDM and 0.17 in IDDM. Among the NIDDM subjects, excess weight gain during pregnancy, as defined by maximum BMI during pregnancy minus basal BMI before pregnancy exceeding five, was observed in 12.2% of the wild-type patients, 19.2% of heterozygotes and 28.6% of homozygotes. Homozygous subjects with NIDDM tended to show excess weight gain during pregnancy, however, this trend did not reach significance. None of the IDDM homozygotes showed excess weight gain. From our study, this beta3-AR gene polymorphism cannot be excluded as a contributing factor to excess weight gain during pregnancy in NIDDM subjects.
孕期体重增加不当对母亲和胎儿的结局均有重大影响。因此,体重增加是糖尿病女性孕期管理中的一个重要问题。据报道,β3 - 肾上腺素能受体(β3 - AR)基因中的色氨酸64被精氨酸替代(Trp64Arg)与非胰岛素依赖型糖尿病(NIDDM)患者的体重增加和肥胖有关。本研究的目的是阐明β3 - AR基因对糖尿病患者孕期体重增加的影响。我们分析了199例糖尿病患者(NIDDM/IDDM;131/68),患者数据来自每个人的首次分娩。糖尿病诊断时的平均年龄为22.9±7.5岁(平均值±标准差),分娩时的平均年龄为29.8±4.5岁。使用识别Trp64Arg替代的Bst OI通过聚合酶链反应 - 限制性片段长度多态性(PCR - RFLP)检测β3 - AR基因的多态性。Trp64Arg等位基因在NIDDM中的频率为0.15,在IDDM中的频率为0.17。在NIDDM患者中,孕期体重过度增加(定义为孕期最大体重指数减去孕前基础体重指数超过5)在野生型患者中为12.2%,杂合子中为19.2%,纯合子中为28.6%。NIDDM纯合子患者在孕期倾向于出现体重过度增加,然而,这种趋势未达到显著水平。IDDM纯合子中均未出现体重过度增加。从我们的研究来看,不能排除这种β3 - AR基因多态性是NIDDM患者孕期体重过度增加的一个促成因素。