摘要
目的:探究妊娠期糖尿病患者血清内脂素(visfatin)、性激素结合球蛋白(SHBG)水平变化及与病情、妊娠结局的相关性。方法:选取2017年11月-2019年12月于本院定期产前检查并分娩的妊娠期糖尿病患者102例(观察组)临床资料,同期健康孕妇98例为对照组。比较两组血清visfatin、SHBG水平及胰岛素抵抗指数(HOMA-IR)、妊娠结局;Pearson法分析妊娠期糖尿病患者血清visfatin、SHBG水平与HOMA-IR相关性;根据是否发生不良妊娠结局,将妊娠期糖尿病患者分为发生组(49例)和未发生组(53例),比较两组血清visfatin、SHBG水平;多因素logistic回归模型分析影响妊娠期糖尿病患者不良妊娠结局发生的危险因素;受试者工作特征曲线(ROC)分析血清visfatin、SHBG对妊娠期糖尿病患者不良妊娠结局发生的评估价值。结果:观察组血清visfatin(64.73±18.26 mmol/L)、HOMA-IR(2.79±0.91)高于对照组(33.59±10.91 mmol/L、1.72±0.63),SHBG(415.05±50.54 mmol/L)低于对照组(573.41±59.68 mmol/L)(均P=0.000)。妊娠期糖尿病患者血清visfatin、SHBG水平与HOMA-IR分别呈正负相关(r=0.469、-0.474,均P=0.000)。观察组合并妊娠期高血压、剖宫产、巨大儿及新生儿低血糖发生率均高于对照组,且发生不良妊娠结局组血清visfatin水平高于未发生组,SHBG水平低于未发生组(均P<0.05);血清visfatin、SHBG水平是影响妊娠期糖尿病患者不良妊娠结局发生的独立危险因素(P<0.05),二者联合检测评估患者不良妊娠结局发生的曲线下面积(0.871)高于单独检测(0.782、0.734)(P<0.05)。结论:妊娠期糖尿病患者血清visfatin水平升高、SHBG水平降低,均与HOMA-IR有一定相关性,可能用于评估患者不良妊娠结局的发生。
Objective: To explore the changes of the levels of serum visfatin and sex hormone-binding globulin(SHBG) of pregnant women with gestational diabetes mellitus(GDM), and to study the correlation between the levels of serum visfatin and SHBG of the women and their condition of GDM and their pregnancy outcomes. Methods: The clinical data of 102 pregnant women with GDM(in observation group) who had received regular prenatal examination and delivery from November 2017 to December 2019 were selected. Another 98 healthy pregnant women were selected in control group during the same period. The expression levels of visfatin and SHBG,the value of homeostasis model assessment of insulin resistance(HOMA-IR), and the pregnancy outcomes of the women were compared between the two groups. Pearson method was used to analyze the correlation between the expression levels of visfatin and SHBG of the women and their HOMA-IR value. According to the occurrence of adverse pregnancy outcomes, the women with GDM were divided into group A(49 women with adverse pregnancy outcomes) and group B(53 women with normal pregnancy outcomes). The expression levels of visfatin and SHBG of the women were compared between group A and group B. Multivariate Logistic regression model analysis was used to analyze the risk factors of the adverse pregnancy outcomes of the women with GDM. Receiver operating characteristic(ROC) curve was used to analyze the value of serum visfatin and SHBG levels of the women with GDM for evaluating their adverse pregnancy outcomes.Results:The serum visfatin level(64.73±18.26mmol/L)and the HOMA-IR value(2.79±0.91)of the women in the observation group were significantly higher than those(33.59±10.91mmol/L and 1.72±0.63)of the women in the control group.The SHBG level(415.05±50.54 mmol/L)of the women in the observation group was significantly lower than that(573.41±59.68mmol/L)of the women in the control group(all P=0.000).The serum visfatin level was positively correlated with their HOMA-IR value(r=0.469,P=0.000),and the serum SHBG level of the women with GDM was negatively correlated with their HOMA-IR value(r=-0.474,P=0.000).The incidences of hypertension,cesarean section,macrosomia,and neonatal hypoglycemia of the women in the observation group were significantly higher than those of the women in the control group.The serum visfatin level of the women in group A was significantly higher than that of the women in group B,but the SHBG level of the women in group A was significantly lower(all P<0.05).The serum visfatin and SHBG levels of the women with GDM were the independent risk factors of their adverse pregnancy outcomes(P<0.05).The area under the curve(0.871)of the combination the serum visfatin and SHBG levels for evaluating the adverse pregnancy outcomes of the women with GDM was significantly higher than that(0.782)of the serum visfatin level alone and that(0.734)of the serum SHBG level alone(P<0.05).Conclusion:The level of visfatin of the women with GDM significantly increases,and the level of SHBG of the women with GDM significantly decreases,and both of which are related to the HOMA-IR value of the women.The levels of serum visfatin and SHBG of the women with GDM may be used to evaluate their adverse pregnancy outcomes.
作者
殷美琴
王永霞
朱晓琴
钱进
胡小玲
YIN Meiqin;WANG Yongxia;ZHU Xiaoqin;QIAN Jin;HU Xiaoling(Rugao People's Hospital,Jiangsu Province,226500)
出处
《中国计划生育学杂志》
2022年第5期1128-1132,共5页
Chinese Journal of Family Planning
关键词
妊娠期糖尿病
内脂素
性激素结合球蛋白
胰岛素抵抗
不良妊娠结局
预测
影响因素
Gestational diabetes mellitus
Visfatin
Sex hormone-binding globulin
Insulin resistance
Adverse preg-nancy outcomes
Prediction
Influence factor
