摘要
目的探讨妊娠期糖尿病患者胰岛素抵抗与血清内脏脂肪组织源性丝氨酸蛋白酶抑制剂(Vaspin)、分泌型卷曲相关蛋白5(Sfrp5)、C反应蛋白(CRP)的相关性。方法选取郑州大学附属郑州中心医院2018年1月—2020年1月收治的妊娠期糖尿病(gestational diabetes mellitus,GDM)患者85例(GDM组)、同期正常妊娠患者85例(对照组),检测两组的血清Vaspin、Sfrp5及CRP及血糖相关代谢指标。采用线性相关分析法探讨血清Vaspin、Sfrp5及CRP与胰岛素抵抗指数的相关性。分析血清Vaspin、Sfrp5及CRP在胰岛素抵抗中的诊断价值。分析胰岛素抵抗指数的影响因素。结果GDM组患者的血清Vaspin、CRP高于对照组(P<0.05),GDM组患者的血清Sfrp5低于对照组(P<0.05)。GDM组患者的血清空腹血糖(FPG)、餐后2h血糖(OGTT2h)、糖化血红蛋白(HbA1c)、空腹胰岛素水平(Fins)及胰岛素抵抗指数(HOMA-IR)水平均高于对照组,(P<0.05)。HOMA-IR与Vaspin水平呈正相关,与Sfrp5水平呈负相关(P<0.05)。血清Vaspin诊断GDM的ROC曲线下面积AUC值为0.783,血清Sfrp5诊断GDM的ROC曲线下面积AUC值为0.670,血清CRP诊断GDM的ROC曲线下面积AUC值为0.693。Logistic回归分析可知,GDM患者Vaspin水平增高、Sfrp5降低均与HOMA-IR增高有关(P<0.05)。结论GDM患者血清Vaspin水平越高、Sfrp5水平越低发生胰岛素抵抗的风险越高,血清Vaspi、Sfrp5、CRP在诊断GDM中具有较好的敏感性和特异性。
Objective To explore the relationship between insulin resistance and serum Vaspin,Sfrp5,CRP in patients with gestational diabetes.Methods Selected 85 cases of GDM women diagnosed in our hospital(GDM group)and 85 cases of normal pregnant women(control group)during the same period,and detect the serum Vaspin,Sfrp5,CRP and blood glucose related metabolic indexes of the two groups.Linear correlation analysis was used to explore the correlation between serum Vaspin,Sfrp5,CRP and insulin resistance index.Analyzed the diagnostic value of serum Vaspin,Sfrp5 and CRP in insulin resistance.Analyzed the influencing factors of insulin resistance index.Results The serum Vaspin and CRP of the GDM group were higher than those of the control group(P<0.05),and the serum Sfrp5 of the GDM group was lower than the control group(P<0.05).The serum FPG,OGTT2 h,HbA1 c,Fins and HOMA-IR levels of the GDM group were higher than those of the control group,(P<0.05).HOMA-IR was positively correlated with Vaspin levels,and negatively correlated with Sfrp5 levels(P<0.05).The AUC value of the area under the ROC curve of serum Vaspin diagnosed GDM was 0.783,and the AUC value of the area under the ROC curve of serum Sfrp5 diagnosed GDM was 0.670,the AUC value of the area under the ROC curve for the diagnosis of GDM by serum CRP was 0.693.Logistic regression analysis showed that the increase of Vaspin level and the decrease of Sfrp5 in GDM patients were related to the increase of HOMA-IR(P<0.05).Conclusion The higher the serum Vaspin level and the lower the Sfrp5 level in GDM patients,the higher the risk of insulin resistance.Serum Vaspi,Sfrp5 and CRP have good sensitivity and specificity in the diagnosis of GDM.
作者
崔玲玲
CUI Ling-ling(Department of Laboratory Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2021年第15期57-60,64,共5页
Journal of Medical Forum
