Li Yuan-yuan, Xiao Rui, Li Cai-ping, Huangfu Jian, Mao Jiang-feng
Department of Endocrinology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China (mainland).
Key Laboratory of Molecular Pathology, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China (mainland).
Med Sci Monit. 2015 Feb 8;21:426-31. doi: 10.12659/MSM.892431.
The aim of this study was to investigate the relationship between plasma fatty acid binding protein 4 (FABP4), phosphatase and tensin homolog (PTEN), and insulin resistance in patients with gestational diabetes mellitus (GDM).
Plasma FABP4 and PTEN were determined by ELISA in GDM patients (GDM group, n=30) and in euglycemic pregnant women (control group, n=30). The clinical features, body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), and lipid profiles were compared between the 2 groups. The influence of risk factors on insulin resistance, including BMI, lipid profiles, FABP4, and PTEN, were further investigated by multiple-factor stepwise regression analysis.
Higher levels of BMI, ΔBMI, triglyceride (TG), fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), fasting insulin, HOMA-IR, FABP4, PTEN, and lower level of high-density lipoprotein cholesterol (HDL-C) were found in the GDM patients than in the controls (all P<0.005). The plasma FABP4 was 1.47±0.25 vs. 0.20±0.07 ng/ml in the GDM and control group, respectively (P<0.0001). Plasma PTEN was 6.46±1.57 vs. 4.72±0.82 ng/ml in the GDM and control group, respectively (P<0.0001). There was a positive relation between plasma FABP4 and PTEN when all blood samples, including GDM and control groups, were analyzed (P<0.05). The multiple-factor regression analysis revealed that plasma FABP4, TG, and PTEN were independent risk factors for increased insulin resistance.
GDM patients have more severe insulin resistance compared to euglycemic pregnant women. Higher levels of plasma FABP4 and PTEN are associated with increased insulin resistance and may participate in the pathogenesis of insulin resistance during gestation.
本研究旨在探讨妊娠期糖尿病（GDM）患者血浆脂肪酸结合蛋白4（FABP4）、磷酸酶和张力蛋白同源物（PTEN）与胰岛素抵抗之间的关系。
采用酶联免疫吸附测定法（ELISA）检测GDM患者（GDM组，n = 30）和血糖正常的孕妇（对照组，n = 30）血浆中的FABP4和PTEN。比较两组的临床特征、体重指数（BMI）、胰岛素抵抗稳态模型评估（HOMA-IR）和血脂谱。通过多因素逐步回归分析进一步研究包括BMI、血脂谱、FABP4和PTEN在内的危险因素对胰岛素抵抗的影响。
GDM患者的BMI、ΔBMI、甘油三酯（TG）、空腹血糖（FPG）、餐后2小时血糖（2hPG）、空腹胰岛素、HOMA-IR、FABP4、PTEN水平高于对照组，高密度脂蛋白胆固醇（HDL-C）水平低于对照组（均P < 0.005）。GDM组和对照组血浆FABP4分别为1.47±0.25 ng/ml和0.20±0.07 ng/ml（P < 0.0001）。GDM组和对照组血浆PTEN分别为6.46±1.57 ng/ml和4.72±0.82 ng/ml（P < 0.0001）。分析包括GDM组和对照组在内的所有血样时，血浆FABP4与PTEN呈正相关（P < 0.05）。多因素回归分析显示，血浆FABP4、TG和PTEN是胰岛素抵抗增加的独立危险因素。
与血糖正常的孕妇相比，GDM患者存在更严重的胰岛素抵抗。血浆FABP4和PTEN水平升高与胰岛素抵抗增加有关，可能参与妊娠期胰岛素抵抗的发病机制。
