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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02936-5

摘要内容如下：

胰岛素敏感性降低（胰岛素抵抗）是妊娠晚期正常生理的标志，也是妊娠期糖尿病（GDM）的基础。我们对434例人类胎盘进行了转录组学分析，发现胎盘中胰岛素样生长因子结合蛋白1基因（IGFBP1）的表达与妊娠26周时的胰岛素敏感性呈正相关。循环IGFBP1蛋白水平在妊娠过程中升高，产后下降，加上我们胎盘样本中的高基因表达水平，提示胎盘或蜕膜来源。在同一队列和另外两个妊娠队列中，妊娠26周时较高的循环IGFBP1水平与较高的胰岛素敏感性（较低的胰岛素抵抗）相关。此外，在两组孕妇中，妊娠早期循环IGFBP1水平低可预测随后的GDM诊断。这些结果暗示IGFBP1在妊娠血糖生理学中的作用，并提示胎盘IGFBP1缺乏在GDM发病机制中的作用。

英文原文如下：

Abstracts

Reduced insulin sensitivity (insulin resistance) is a hallmark of normal physiology in late pregnancy and also underlies gestational diabetes mellitus (GDM). We conducted transcriptomic profiling of 434 human placentas and identified a positive association between insulin-like growth factor binding protein 1 gene (IGFBP1) expression in the placenta and insulin sensitivity at ~26 weeks gestation. Circulating IGFBP1 protein levels rose over the course of pregnancy and declined postpartum, which, together with high gene expression levels in our placenta samples, suggests a placental or decidual source. Higher circulating IGFBP1 levels were associated with greater insulin sensitivity (lesser insulin resistance) at ~26 weeks gestation in the same cohort and in two additional pregnancy cohorts. In addition, low circulating IGFBP1 levels in early pregnancy predicted subsequent GDM diagnosis in two cohorts of pregnant women. These results implicate IGFBP1 in the glycemic physiology of pregnancy and suggest a role for placental IGFBP1 deficiency in GDM pathogenesis.

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