Cao Weiping, Wang Xinzhi, Chen Tingmei, Xu Wenlin, Feng Fan, Zhao Songlan, Wang Zuxian, Hu Yu, Xie Bing
Department of Obstetrics, Maternity and Child Health Hospital of Zhenjiang, Zhenjiang, Jiangsu 212001, P.R. China.
Department of Nursing, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.
Exp Ther Med. 2018 Jul;16(1):427-435. doi: 10.3892/etm.2018.6144. Epub 2018 May 10.
The objective of the present study was to investigate the role of blood glucose, lipid metabolism, body mass index (BMI), C-reactive protein (CRP) as well as an interleukin (IL)-17/IL-35 imbalance in the pathogenesis of concurrent gestational diabetes mellitus (GDM) and preeclampsia (PE) (DPE). The mRNA expression of forkhead box protein 3 (FoxP3), IL-35 [including Epstein-Barr virus-induced gene 3 (EBI3) and P35 subunits] and IL-17 in the peripheral blood mononuclear cells of patients with DPE (n=30), GDM (n=33), PE (n=33) and normal pregnancy (n=33) were determined by reverse transcription-quantitative polymerase chain reaction. The serum levels of IL-35, IL-17 and CRP were analyzed using ELISA. Serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and fasting blood glucose (FBG) were also detected. The levels of low-density lipoprotein (LDL) were calculated using the Friedewald formula. Body weight and height were determined in order to calculate the BMI. It was observed that the levels of FBG were markedly elevated in patients with GDM, PE and DPE. In addition, significantly higher serum TG, TC, LDL and very LDL were detected in patients with GDM, PE and DPE compared with those in subjects with normal pregnancies. By contrast, the concentration of HDL was lower in the patient groups. In addition, higher BMI values were identified in patients with GDM, PE and DPE. A decreased expression of FoxP3, P35 and EBI3 mRNA, and an elevated expression of IL-17 in PBMCs was detected in patients with GDM, PE and DPE. In addition, higher serum levels of IL-17 and CRP, as well as lower levels of IL-35, were observed. Furthermore, in patients with DPE, positive correlations of diastolic blood pressure with IL-17 levels, BMI and TG, as well as IL-17 levels with BMI and proteinuria were identified. In conclusion, the present study indicated that abnormal maternal lipids, hyperglycemia, high BMI, high CRP and IL-17/IL-35 imbalance may have a role in the pathophysiology of DPE. Therefore, pregnant women and clinicians should be made aware that maternal hyperlipidaemia, hyperglycemia, high BMI, high CRP levels and IL-17/IL-35 imbalance may lead to DPE.
本研究的目的是探讨血糖、脂质代谢、体重指数（BMI）、C反应蛋白（CRP）以及白细胞介素（IL）-17/IL-35失衡在妊娠合并糖尿病（GDM）和先兆子痫（PE）（即双重子痫前期，DPE）发病机制中的作用。采用逆转录-定量聚合酶链反应测定DPE患者（n=30）、GDM患者（n=33）、PE患者（n=33）及正常妊娠者（n=33）外周血单个核细胞中叉头框蛋白3（FoxP3）、IL-35[包括EB病毒诱导基因3（EBI3）和P35亚基]和IL-17的mRNA表达。采用酶联免疫吸附测定法分析血清IL-35、IL-17和CRP水平。还检测了血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）和空腹血糖（FBG）。采用Friedewald公式计算低密度脂蛋白（LDL）水平。测定体重和身高以计算BMI。结果观察到，GDM、PE和DPE患者的FBG水平显著升高。此外，与正常妊娠者相比，GDM、PE和DPE患者的血清TG、TC、LDL和极低密度脂蛋白水平显著更高。相比之下，患者组的HDL浓度较低。此外，GDM、PE和DPE患者的BMI值更高。在GDM、PE和DPE患者中检测到外周血单个核细胞中FoxP3、P35和EBI3 mRNA表达降低，而IL-17表达升高。此外，观察到血清IL-17和CRP水平升高，而IL-35水平降低。此外，在DPE患者中，舒张压与IL-17水平、BMI和TG呈正相关，IL-17水平与BMI和蛋白尿呈正相关。总之，本研究表明，孕妇脂质异常、高血糖、高BMI、高CRP以及IL-17/IL-35失衡可能在DPE的病理生理过程中起作用。因此，应让孕妇和临床医生意识到，孕妇高脂血症、高血糖、高BMI、高CRP水平以及IL-17/IL-35失衡可能导致DPE。
