Insulin receptors and placental proteins in normal and gestational-diabetic pregnancies.

N Neufeld, G Braunstein, L M Corbo, J Gratacos, J Mestman
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Abstract

We studied 125I-insulin binding to monocytes and plasma levels of two trophoblastic proteins from 38 pregnant patients with varying degrees of carbohydrate intolerance, including 10 pregnant controls (PC), 17 Class A diabetics (A), 6 Class B diabetics - prior to insulin therapy (B-noRx) and 5 different Class B diabetics studied 1-6 weeks following initiation of insulin therapy (B-Rx). All studies were performed in the second half of pregnancy. In comparison to six age- and weight-matched nonpregnant controls (NPC), insulin binding to monocytes was somewhat higher in both PC and A. B.noRx patients had significantly lower tracer binding than did PC (0.71 +/- 0.3 vs 2.6 +/- 0.6%/10(7) cells, p less than 0.01). Insulin treatment of Class B patients restored insulin tracer binding levels to above normal. Levels of human placental lactogen (HPL) were significantly elevated in B-noRx patients compared to PC and A and were lowered to levels comparable to normal in insulin-treated B patients. A highly significant inverse relationship existed between HPL levels and the tracer binding of insulin for all patients studied (r = -0.52, p less than 0.005). Elevations of pregnancy-specific beta 1 glycoprotein were observed in patients with mild carbohydrate intolerance (A) as well as Bno-Rx, but were comparable to normal in those B-patients receiving insulin therapy. There were no significant differences of insulin binding or receptor number in the patient groups in the postpartum state. This further supports the hypothesis that placental factors may be responsible for the insulin binding defects seen in gestational diabetes.

正常妊娠和妊娠糖尿病妊娠的胰岛素受体和胎盘蛋白。
我们研究了38名不同程度碳水化合物不耐受的妊娠患者的125i -胰岛素与单核细胞的结合和两种滋养层蛋白的血浆水平,包括10名妊娠对照组(PC), 17名A级糖尿病患者(A), 6名B级糖尿病患者-胰岛素治疗前(B- norx)和5名不同的B级糖尿病患者在胰岛素治疗开始后1-6周(B- rx)。所有的研究都是在怀孕的后半段进行的。与6个年龄和体重匹配的未怀孕对照组(NPC)相比,PC和A. B.noRx患者的胰岛素与单核细胞的结合略高,其示踪剂结合明显低于PC (0.71 +/- 0.3 vs 2.6 +/- 0.6%/10(7)个细胞,p < 0.01)。B类患者胰岛素治疗后,胰岛素示踪剂结合水平恢复到正常以上。与PC和A患者相比,B- norx患者的人胎盘乳原(HPL)水平显著升高,而胰岛素治疗的B患者的HPL水平降至与正常水平相当。在所有研究的患者中,HPL水平与胰岛素示踪剂结合之间存在高度显著的负相关(r = -0.52, p < 0.005)。在轻度碳水化合物不耐受(A)和Bno-Rx患者中观察到妊娠特异性β 1糖蛋白升高,但在接受胰岛素治疗的b组患者中与正常水平相当。两组患者产后状态胰岛素结合及受体数量无显著差异。这进一步支持了胎盘因素可能导致妊娠糖尿病中胰岛素结合缺陷的假设。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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