中文摘要：

目的：探讨妊娠晚期妇女脂肪组织中11β-羟类固醇脱氢酶Ⅰ型（11β-HSD1）及脂联素mRNA表达水平的变化及其临床意义。方法：取剖宫产妇女33例（正常妊娠22例,妊娠糖尿病11例）以及14例开腹手术的育龄期非妊娠妇女（非妊娠组）的皮下和网膜脂肪组织,应用实时定量PCR方法测定脂肪组织11β-HSD1和脂联素mRNA水平。结果：与非妊娠妇女比较,孕晚期正常妊娠和妊娠糖尿病妇女皮下和网膜组织11β-HSD1基因mRNA表达水平均明显增加（P〈0.001）,而脂联素基因mRNA表达水平均明显下降（P〈0.01）。皮下和网膜配对比较显示,孕晚期正常妊娠和GDM妇女网膜脂肪组织11β-HSD1基因表达水平均明显高于皮下（P〈0.05）,而脂联素表达水平无显著部位差异（P=0.08）。相关分析显示,妊娠糖尿病妇女皮下脂联素表达与母血胆固醇（r=-0.779,P=0.003）、低密度脂蛋白（r=-0.664,P=0.029）负相关,而网膜11β-HSD1与孕期增加的BMI（r=0.323,P=0.043）及新生儿胰岛素抵抗指数呈正相关（r=0.618,P=0.032）。结论：妊娠晚期脂肪组织11β-HSD1mRNA表达增加和脂联素mRNA表达水平的下降,这可能是妊娠期间脂肪组织积聚,能量代谢增加产生的一种适应性分子变化,其在妊娠糖尿病的发生发展中的作用值得关注和进一步研究。

英文摘要：

Objective：To observe the expression of 11β-hydroxysteroid dehydrogenase type Ⅰ（11β-HSD1） and adiponectin mRNA in abdominal subcutaneous and omental adipose tissue of pregnant women with third-trimester. Methods：Paired biopsies （subcutaneous and omental） were obtained from 33 third-trimester women （normal pregnant control,n=22;gestational diabetes mellitus,GDM, n=11） and 14 non-pregnant child-bearing period women （the non-pregnant group）. 11β-HSD1 and adiponectin mRNA expressions in paired adipose tissue were measured by real time PCR. Results：Compared to the non-pregnant group,the expressions of 11β-HSD1 mRNA in the normal pregnant group and the GDM group were increased in both subcutaneous and omental adipose tissue,inversely the expressions of adiponectin mRNA were significantly down-regulated in subcutaneous and omental adipose tissue. Moreover,the expression of 11β-HSD1 mRNA in omental adipose tissue was higher than that in subcutaneous in the normal pregnant group and the GDM group,there was no significant depot difference in adiponectin mRNA expression. Furthermore,adiponectin mRNA expression in subcutaneous adipose tissue in the GDM was negatively correlated with TC （r=-0.779,P=0.003） and LDL-C （r=-0.664,P=0.029）,while the 11β-HSD1 mRNA in omental adipose tissue was positively correlated with BMI increasing during pregnancy （r=0.323,P=0.043） and HOMA-IR of the newborns （r=0.618,P=0.032）. Conclusion：The expression of 11β-HSD1 was increased while the expression of adiponectin was decreased in adipose tissue after pregnancy,which suggested that it could be a sort of adaptive change resulting from glucose and lipid metabolism during pregnancy. Their effect on the development of GDM should be concerned and further studied.