妊娠期糖尿病孕妇的甘油三酯、脂肪酸转运蛋白、Toll 样受体 4 水平升高，高密度脂蛋白胆固醇水平降低，且与新生儿体重密切相关。

Higher Levels of Triglyceride, Fatty Acid Translocase, and Toll-Like Receptor 4 and Lower Level of HDL-C in Pregnant Women with GDM and Their Close Correlation with Neonatal Weight.

机构信息

Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan, China.

Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan, China,

出版信息

Gynecol Obstet Invest. 2021;86(1-2):48-54. doi: 10.1159/000510032. Epub 2021 Jan 22.

DOI:10.1159/000510032

PMID:33486480

Abstract

OBJECTIVES

In this study, we aimed to compare the levels of maternal blood lipids, placental and venous blood lipid transporters, and inflammatory factor receptors in pregnant women with and without gestational diabetes mellitus (GDM). We also aimed to figure out the relationship between these values and neonatal weight.

METHODS

Fifty pregnant women with GDM under blood glucose control belong to the case group, and 50 pregnant women with normal glucose tolerance in concurrent delivery belong to the control group. Fasting venous blood of these pregnant women was taken 2 weeks before delivery, and umbilical cord blood was collected after delivery. The levels of triglyceride (TG), serum total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C) in maternal blood and umbilical cord blood were tested in the laboratory department of our hospital. The level of toll-like receptor 4 (TLR4) in serum of umbilical veins was detected by the double-antibody sandwich ELISA. Western blot and RT-PCR were used to detect the protein and mRNA expressions of TLR4, LPL, and FAT/CD36 in the placenta.

RESULTS

The level of TG in maternal blood in the case group was remarkably higher than that in the control group, which was opposite to the level of HDL-C. In the umbilical cord blood of women with GDM, the expression of TLR4 increased and was closely correlated with neonatal weight. In the placenta of women with GDM, the expressions of FAT/CD36 and TLR4 increased, and both of them were closely correlated with neonatal weight. Besides, TLR4 in umbilical cord blood increased and was closely correlated with neonatal weight. Although the expression of LPL in the placenta decreased, it had no obvious correlation with neonatal weight.

CONCLUSIONS

TG in maternal blood, TLR4 in the placenta and umbilical cord blood, and FAT/CD36 in the placenta were positively correlated with neonatal weight. However, HDL-C in maternal blood was negatively correlated with neonatal weight. Although the expression of LPL in the placenta reduced due to GDM, it had no correlation with neonatal weight.

摘要

目的

本研究旨在比较患有和未患有妊娠期糖尿病（GDM）的孕妇的血脂水平、胎盘和静脉血脂质转运体以及炎症因子受体，并探讨这些值与新生儿体重之间的关系。

方法

选取 50 例血糖控制良好的 GDM 孕妇作为病例组，同期分娩的 50 例糖耐量正常孕妇作为对照组。于分娩前 2 周采集孕妇空腹静脉血，分娩后采集脐静脉血。检测我院检验科孕妇母血和脐血中甘油三酯（TG）、血清总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇（HDL-C）水平。采用双抗体夹心 ELISA 法检测血清中 toll 样受体 4（TLR4）的水平。采用 Western blot 和 RT-PCR 检测 TLR4、LPL、FAT/CD36 在胎盘组织中的蛋白和 mRNA 表达。

结果

病例组母血中 TG 水平显著高于对照组，而 HDL-C 水平则相反。GDM 孕妇脐静脉血中 TLR4 表达增加，与新生儿体重密切相关。GDM 孕妇胎盘组织中 FAT/CD36 和 TLR4 表达增加，均与新生儿体重密切相关。此外，脐静脉血中 TLR4 增加与新生儿体重密切相关。虽然胎盘组织中 LPL 的表达减少，但与新生儿体重无明显相关性。