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妊娠高血压与胰岛素抵抗相关性的临床研究

Clinical study on the association between pregnancy-induced hypertension and insulin resistance.

作者信息

Chen Zhifang, Liu Weiling, Sun Xiaoqin, Zhu Lingling

机构信息

Department of Obstetrics and Gynecology, Nantong Maternity and Child Health Care Hospital Affiliated to Nantong University, Nantong, Jiangsu 226018, P.R. China.

出版信息

Exp Ther Med. 2017 May;13(5):2065-2070. doi: 10.3892/etm.2017.4169. Epub 2017 Mar 2.

Abstract

The aim of the present study was to explore the association between pregnancy-induced hypertension (PIH) and insulin resistance (IR). A total of 50 cases of PIH and 50 healthy pregnant women with a similar gestational age were enrolled. The hyperinsulinemic-euglycemic clamp technique was used to evaluate the degree of IR and all 100 subjects were divided into an IR and a non-IR group accordingly. Subsequently, the correlation between the systolic or diastolic blood pressure was assessed; furthermore, a homeostasis model assessment of IR (HOMA-IR), a HOMA of the insulin sensitivity index (HOMA-ISI) and a HOMA of β cell function (HOMA-β%) were performed. Moreover, the effect of IR on PIH was assessed and the protein expression of insulin receptor substrate (IRS)-1, phosphorylated (p)-IRS-1, AKT and p-AKT were detected in the placental plasma by western blot analysis. The results showed that in the PIH group, the p-IRS-1/IRS-1 and p-AKT/AKT ratios were decreased compared with those in the control group. Blood flow parameters, including perfusion index, retinal resistive index and systolic maximum velocity/end-diastolic velocity ratio in the IR group were higher, while time averaged velocity was lower compared with that in the non-IR group. Furthermore, the HOMA-ISI and HOMA-β% were decreased, while the HOMA-IR was increased in the PIH group compared to that in the control group; alongside the blockage of the insulin signaling pathway, these factors may therefore cause PIH. The present study may provide novel therapeutic approaches for PIH.

摘要

本研究的目的是探讨妊娠高血压综合征(PIH)与胰岛素抵抗(IR)之间的关联。共纳入50例PIH患者和50例孕周相近的健康孕妇。采用高胰岛素-正葡萄糖钳夹技术评估IR程度,并据此将所有100名受试者分为IR组和非IR组。随后,评估收缩压或舒张压之间的相关性;此外,进行了IR的稳态模型评估(HOMA-IR)、胰岛素敏感性指数的HOMA(HOMA-ISI)和β细胞功能的HOMA(HOMA-β%)。此外,评估了IR对PIH的影响,并通过蛋白质印迹分析检测胎盘血浆中胰岛素受体底物(IRS)-1、磷酸化(p)-IRS-1、AKT和p-AKT的蛋白表达。结果显示,PIH组中p-IRS-1/IRS-1和p-AKT/AKT比值低于对照组。IR组的血流参数,包括灌注指数、视网膜阻力指数和收缩期最大速度/舒张末期速度比值较高,而平均时间速度低于非IR组。此外,与对照组相比,PIH组的HOMA-ISI和HOMA-β%降低,而HOMA-IR升高;因此,这些因素连同胰岛素信号通路的阻断可能导致PIH。本研究可能为PIH提供新的治疗方法。

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