妊娠合并糖尿病时胎盘葡萄糖转运蛋白GLUT-1、GLUT-4和GLUT-9的表达与选定的母体和胎儿参数之间的相关性分析
Analysis of correlations between the placental expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus.
作者信息
Stanirowski Paweł Jan, Szukiewicz Dariusz, Pyzlak Michał, Abdalla Nabil, Sawicki Włodzimierz, Cendrowski Krzysztof
机构信息
a Department of Obstetrics, Gynecology and Oncology, II Faculty of Medicine , Medical University of Warsaw, Mazovian Bródno Hospital , Warsaw , Poland.
b Department of General and Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), II Faculty of Medicine , Medical University of Warsaw , Warsaw , Poland.
出版信息
J Matern Fetal Neonatal Med. 2019 Feb;32(4):650-659. doi: 10.1080/14767058.2017.1387897. Epub 2017 Oct 16.
PURPOSE
The aim of the study was to analyze the correlations between the expression of glucose transporters GLUT-1, GLUT-4, and GLUT-9 in human term placenta and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus (DM).
MATERIALS AND METHODS
Placental samples were obtained from healthy control (n = 25) and diabetic pregnancies, including diet-controlled gestational diabetes mellitus (GDMG1) (n = 16), insulin-controlled gestational diabetes mellitus (GDMG2) (n = 6), and pregestational DM (PGDM) (n = 6). Computer-assisted quantitative morphometry of stained placental sections was performed to determine the expression of selected glucose transporter proteins. For the purposes of correlation analysis, the following parameters were selected: type of diabetes, gestational age, maternal prepregnancy body mass index (BMI), gestational weight gain, third trimester glycated hemoglobin concentration, placental weight, fetal birth weight (FBW) as well as ultrasonographic indicators of fetal adiposity, including subscapular (SSFM), abdominal (AFM), and midthigh (MTFM) fat mass measurements.
RESULTS
In the PGDM group, the analysis demonstrated positive correlations between the placental expression of GLUT-1, GLUT-4, and GLUT-9 and FBW, AFM, and SSFM measurements (p < .05). Similarly in the GDMG2 patients positive correlations between GLUT-4 expression, FBW and SSFM were observed (p < .05). In the multivariate regression analysis, only the type of diabetes and FBW were significantly associated with GLUTs expression (p < .001). In addition, maternal prepregnancy BMI significantly contributed to GLUT-1 expression (p < .001).
CONCLUSIONS
The study results revealed that placental expression of GLUT-1, GLUT-4, and GLUT-9 may be involved in the intensification of the fetal growth in pregnancies complicated by GDM/PGDM.
目的
本研究旨在分析妊娠合并糖尿病（DM）时，人足月胎盘葡萄糖转运蛋白GLUT-1、GLUT-4和GLUT-9的表达与选定的母体和胎儿参数之间的相关性。
材料与方法
胎盘样本取自健康对照组（n = 25）以及糖尿病妊娠组，包括饮食控制的妊娠期糖尿病（GDMG1）（n = 16）、胰岛素控制的妊娠期糖尿病（GDMG2）（n = 6）和孕前糖尿病（PGDM）（n = 6）。对染色的胎盘切片进行计算机辅助定量形态测定，以确定选定葡萄糖转运蛋白的表达。为进行相关性分析，选择了以下参数：糖尿病类型、孕周、母体孕前体重指数（BMI）、孕期体重增加、孕晚期糖化血红蛋白浓度、胎盘重量、胎儿出生体重（FBW）以及胎儿肥胖的超声指标，包括肩胛下（SSFM）、腹部（AFM）和大腿中部（MTFM）脂肪量测量。
结果
在PGDM组中，分析表明GLUT-1、GLUT-4和GLUT-9的胎盘表达与FBW、AFM和SSFM测量值之间呈正相关（p < 0.05）。同样，在GDMG2患者中，观察到GLUT-4表达与FBW和SSFM之间呈正相关（p < 0.05）。在多变量回归分析中，只有糖尿病类型和FBW与GLUTs表达显著相关（p < 0.001）。此外，母体孕前BMI对GLUT-1表达有显著贡献（p < 0.001）。
结论
研究结果表明，GLUT-1、GLUT-4和GLUT-9的胎盘表达可能参与了GDM/PGDM合并妊娠时胎儿生长的加速。
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