摘要【目的】探讨脂代谢相关基因乙酰辅酶A羧化酶(ACC)、脂蛋白脂酶(LPL)在胎盘组织中表达及其与妊娠期糖尿病(GDM)巨大儿的相关性。【方法】选择2015年1月至2018年1月在本院就诊GDM患者241例,其中新生儿出生体质量＞4000 g(巨大儿) 48例(A组);新生儿出生体质量≤4000 g (正常体质量)193例(B组)。在分娩前采集血清样本检测脂代谢、载脂蛋白等指标水平,分娩后取胎儿面胎盘组织作为检测样本,比较两组新生儿母亲一般资料,并应用RT-PCR法检测ACC-mRNA、LPL-mRNA表达水平,分析ACC-mRNA、LPL-mRNA表达水平与GDM巨大儿的相关性。【结果】两组新生儿母亲年龄、分娩前BMI、孕期体质量差值、三酰甘油(TG)、血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白AⅡ(ApoAⅡ)、载脂蛋白CⅢ(ApoCⅢ)、糖化血红蛋白(HbA1C)比较差异均无统计学意义(P>0.05);A组ACC-mRNA相对表达量为2.01±0.39,显著高于B组的1.07±0.12,其差异有统计学意义(t=28.615,P=0.000);LPL-mRNA表达量为0.49±0.02,显著低于B组的0.61±0.04,其差异有统计学意义(t=20.144,P=0.000)。经Spearman相关性分析,胎盘组织中ACC-mRNA表达水平与巨大儿显著正相关(r=6.917,P<0.001),LPL-mRNA表达水平与巨大儿显著负相关(r=6.017,P<0.001)。【结论】胎盘组织中脂代谢相关基因ACC、LPL表达水平异常,其与GDM巨大儿发生密切相关。
Abstract：【Objective】To investigate the expression of acetylcoa carboxylase (ACC) and lipoprotein lipase (LPL) in placenta and their relationship with gestational diabetes mellitus (GDM) macrosomia. 【Methods】From January 2015 to January 2018, 241 GDM patients were selected in our hospital, including 48 cases (group A) with birth weight > 4000 g (macrosomia), 193 cases (group B) with birth weight ≤ 4000 g (normal body weight). Before delivery, serum samples were collected to detect lipid metabolism, apolipoprotein and other indicators. After delivery, fetal placenta tissue was taken as test samples. The general data of two groups of newborn mothers were compared. The expression levels of ACC-mRNA and LPL mRNA were detected by RT-PCR. The correlation between the expression levels of acc-mrna and LPL mRNA and GDM macrosomia was analyzed. 【Results】There were no significant differences between the two groups in maternal age, BMI before delivery, body mass difference during pregnancy, TG, TC, HDL-C, LDL-C, ApoA Ⅱ, ApoC Ⅲ and HbA1c (P>0.05) The relative expression of acc-mrna in the group A was 2.01 ± 0.39, which was significantly higher than that in group B (1.07±0.12,t=28.615, P=0.000); the expression of LPL-mRNA was 0.49 ± 0.02, which was significantly lower than that in the group B (0.61 ± 0.04,t=20.144,P=0.000). According to Spearman's correlation analysis, the expression level of ACC mRNA in placenta was positively correlated with macrosomia (r=6.917, P<0.001), and the expression level of LPL mRNA was negatively correlated with macrosomia (r=6.017,P<0.001). 【Conclusion】The abnormal expression of ACC and LPL in placenta is closely related to the development of GDM macrosomia.
高燕, 陈必良, 刘朵朵, 魏莉. 脂代谢相关基因ACC、LPL在胎盘组织中表达水平及其与妊娠期糖尿病巨大儿的相关性分析[J]. 医学临床研究, 2019, 36(11): 2128-2130.
GAO Yan, CHEN Bi-liang, LIU Duo-duo, et al. Expression level of ACC and LPL in Placenta and their Correlation with Gestational Diabetic Macrosomia. JOURNAL OF CLINICAL RESEARCH, 2019, 36(11): 2128-2130.
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2019, Vol. 36 
