Sex dimorphism in the associations of gestational diabetes with cord blood adiponectin and retinol-binding protein 4.
Sex dimorphism in the associations of gestational diabetes with cord blood adiponectin and retinol-binding protein 4.
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妊娠期糖尿病与脐带血脂联素和视黄醇结合蛋白 4 相关性的性别二态性
DOI：
10.1136/bmjdrc-2020-001310
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发表时间：
2020-09
影响因子：
4.1
通讯作者：
Luo ZC
中科院分区：
文献类型：
--
作者：
Yang MN;Chiu HC;Wang WJ;Fang F;Zhang GH;Zhu H;Zhang L;Zhang DL;Du Q;He H;Huang R;Liu X;Li F;Zhang J;Ouyang F;Hua X;Luo ZC
前言：糖尿病（GD）与新生儿胰岛素敏感性受损有关。脂联素和视黄醇结合蛋白4（RBP-4）参与调节胰岛素敏感性。女性比男性更容易在年轻时患糖尿病。我们检验了GD可能影响生命早期的RBP-4和脂联素水平的假设，并且可能存在性别二态性相关性。研究设计和方法在一项巢式病例对照研究中，我们评估了153对配对的新生儿的母亲GD和正常血糖在上海出生队列，脐带血浆瘦素，高分子量（HMW）和总脂联素和RBP-4的浓度。结果比较GD妊娠与正常血糖妊娠，校正了母儿和新生儿的特征，（平均值±标准差：30.8±14.3 vs 37.1±16.1 µg/mL，p=0.048）和HMW脂联素（14.6±7.7 vs 19.3±8.3 µg/mL，p=0.004）浓度较低，而RBP-4浓度较高（21.7±5.4 vs 20.0±4.8 µg/mL，p=0.007）。与此相反，在男性新生儿中没有差异（所有p>0.2）。仅在GD妊娠中，女性新生儿的RBP-4浓度高于男性新生儿（21.7±5.4 vs 18.8±4.5 µg/mL，p<0.001）。仅血糖正常妊娠的女性新生儿的HMW脂联素浓度显著高于男性新生儿（19.3±8.3 vs 16.1±7.4 µg/mL，p=0.014）。结论GD仅在女性新生儿中与较低的脐带血浆HMW脂联素和较高的RBP-4浓度相关。这项研究首次揭示了GD对后代代谢健康生物标志物的性别二态性早期影响。GD可能会改变生命早期某些胰岛素敏感性调节相关脂肪因子中正常存在（HMW脂联素）或不存在（RBP-4）的性别二态性。
Introduction Gestational diabetes (GD) is associated with impaired insulin sensitivity in newborns. Adiponectin and retinol-binding protein 4 (RBP-4) are involved in regulating insulin sensitivity. Females are more likely to develop diabetes at young ages than males. We tested the hypothesis that GD may affect RBP-4 and adiponectin levels in early life, and there may be sex-dimorphic associations. Research design and methods In a nested case–control study of 153 matched pairs of neonates of mothers with GD and euglycemic pregnancies in the Shanghai Birth Cohort, we evaluated cord plasma leptin, high molecular weight (HMW) and total adiponectin and RBP-4 concentrations. Results Comparing GD versus euglycemic pregnancies adjusted for maternal and neonatal characteristics in female newborns, cord plasma total adiponectin (mean±SD: 30.8±14.3 vs 37.1±16.1 µg/mL, p=0.048) and HMW adiponectin (14.6±7.7 vs 19.3±8.3 µg/mL, p=0.004) concentrations were lower, while RBP-4 concentrations were higher (21.7±5.4 vs 20.0±4.8 µg/mL, p=0.007). In contrast, there were no differences in male newborns (all p>0.2). RBP-4 concentrations were higher in female versus male newborns (21.7±5.4 vs 18.8±4.5 µg/mL, p<0.001) in GD pregnancies only. HMW adiponectin concentrations were significantly higher in female versus male newborns in euglycemic pregnancies only (19.3±8.3 vs 16.1±7.4 µg/mL, p=0.014). Conclusions GD was associated with lower cord plasma HMW adiponectin and higher RBP-4 concentrations in female newborns only. The study is the first to reveal a sex-dimorphic early life impact of GD on metabolic health biomarkers in the offspring. GD may alter the normal presence (HMW adiponectin) or absence (RBP-4) of sex dimorphism in some insulin sensitivity regulation-relevant adipokines in early life.
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