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正常妊娠和复杂妊娠中母体及胎儿抵抗素和脂联素的浓度

Maternal and foetal resistin and adiponectin concentrations in normal and complicated pregnancies.

作者信息

Cortelazzi Donatella, Corbetta Sabrina, Ronzoni Stefania, Pelle Francesca, Marconi Annamaria, Cozzi Veronica, Cetin Irene, Cortelazzi Riccardo, Beck-Peccoz Paolo, Spada Anna

机构信息

Endocrine Unit, Department of Medical Sciences, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.

出版信息

Clin Endocrinol (Oxf). 2007 Mar;66(3):447-53. doi: 10.1111/j.1365-2265.2007.02761.x.

Abstract

OBJECTIVE

The aim of this study was to evaluate how resistin and adiponectin (ApN) are involved in maternal energy metabolism and foetal growth.

DESIGN

A cross-sectional study.

PATIENTS AND MEASUREMENTS

Resistin and ApN were measured in 30 healthy nonpregnant women, 73 pregnant women [10-41 weeks of gestation; 18 with gestational diabetes mellitus (GDM), five with pregnancy-induce hypertension (PIH), nine with pre-eclampsia (PE), eight with chronic hypertension (CH) and 33 normal] and 40 foetal samples (20-41 weeks of gestation; 18 from GDM mothers and 22 from normal mothers).

RESULTS

Resistin levels were significantly higher in normal pregnant women than in nonpregnant controls (13.7 +/- 2.1 vs. 6.3 +/- 1.6 ng/ml; P < 0.005) and showed a negative correlation with gestational age (P < 0.0001, r = -0.7). Only women with PE presented resistin levels significantly lower than normotensive women of the same gestational age (8.2 +/- 1.2 vs. 17.9 +/- 4.3 ng/ml; P < 0.005). ApN levels, although similar in normal pregnant women to those in nonpregnant controls, were significantly lower in women with GDM (37-41 weeks; 5.2 +/- 0.5 vs. 8.2 +/- 0.8 mg/l; P < 0.0001) and PE (20-37 weeks; 5.0 +/- 0.7 vs. 9.5 +/- 0.7 mg/l; P = 0.008) than those found in normal women matched for gestational age. Resistin was detected in the umbilical venous blood in foetuses from 20 to 41 weeks of gestation. In all newborns, both resistin and ApN levels were significantly higher than those recorded in adult life and did not correlate with maternal levels (P = ns, r = 0.03 for resistin and P = ns, r = -0.3 for ApN). Foetuses from diabetic mothers had ApN significantly lower than normal foetuses (26.8 +/- 2.6 vs. 37.5 +/- 3.5 mg/l; P = 0.02), while resistin levels were similar (17.3 +/- 3.7 vs. 18.2 +/- 1.5 ng/ml; P = ns).

CONCLUSION

The secretion pattern of ApN in normal and complicated pregnancies strongly suggests an involvement of ApN in insulin resistance during gestation, while resistin seems to have a minor role. Moreover, the detection of high levels of resistin and ApN in cord blood during gestation is consistent with a regulatory action of these adipokines on tissue differentiation and foetal growth.

摘要

目的

本研究旨在评估抵抗素和脂联素(ApN)如何参与母体能量代谢和胎儿生长。

设计

横断面研究。

患者及测量指标

检测了30名健康未孕女性、73名孕妇[妊娠10 - 41周;18例患有妊娠期糖尿病(GDM),5例患有妊娠高血压(PIH),9例患有子痫前期(PE),8例患有慢性高血压(CH),33例正常]以及40份胎儿样本(妊娠20 - 41周;18例来自GDM母亲,22例来自正常母亲)的抵抗素和ApN水平。

结果

正常孕妇的抵抗素水平显著高于未孕对照组(13.7±2.1对6.3±1.6 ng/ml;P<0.005),且与孕周呈负相关(P<0.0001,r = -0.7)。仅患有PE的女性抵抗素水平显著低于相同孕周的血压正常女性(8.2±1.2对17.9±4.3 ng/ml;P<0.005)。ApN水平在正常孕妇中虽与未孕对照组相似,但在患有GDM(妊娠37 - 41周;5.2±0.5对8.2±0.8 mg/l;P<0.0001)和PE(妊娠20 - 37周;5.0±0.7对9.5±0.7 mg/l;P = 0.008)的女性中显著低于与之孕周匹配的正常女性。在妊娠20至41周胎儿的脐静脉血中检测到抵抗素。在所有新生儿中,抵抗素和ApN水平均显著高于成人水平,且与母体水平无关(P = 无显著性差异,抵抗素r = 0.03,ApN r = -0.3)。糖尿病母亲的胎儿ApN显著低于正常胎儿(26.8±2.6对37.5±3.5 mg/l;P = 0.02),而抵抗素水平相似(17.3±3.7对18.2±1.5 ng/ml;P = 无显著性差异)。

结论

正常及复杂妊娠中ApN的分泌模式强烈提示ApN参与妊娠期胰岛素抵抗,而抵抗素似乎作用较小。此外,妊娠期脐血中高水平的抵抗素和ApN的检测结果与这些脂肪因子对组织分化和胎儿生长的调节作用一致。

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