摘要
目的探讨孕早期妇女血清人吻素(human kisspeptin)、网膜素-1(omentin-1)和Lipasin水平检测对早期预测妊娠糖尿病(gestational diabetes mellitus,GDM)发生风险的价值。方法选取2018年3月~2021年3月廊坊市第四人民医院接受定期产前检查的孕妇256例,根据孕中期口服葡萄糖耐量实验(OGTT)检查结果分为GDM组(n=136)和非GDM组(n=120)。比较两组一般临床资料、孕早期人吻素、网膜素-1和Lipasin血清水平。结果①与非GDM组比较,GDM组孕早期人吻素(3.35±0.95 nmol/L vs 2.19±0.76 nmol/L),Lipasin(3.29±0.43 ng/ml vs 1.07±0.06 ng/ml)血清水平增高(t=4.964,16.798,均P<0.01),孕早期网膜素-1(216.73±70.16 ng/ml vs 278.09±93.45 ng/ml)血清水平降低(t=3.326,P<0.05),差异均有统计学意义。②孕早期人吻素血清水平与孕前BMI,孕24周前增重、TG,FBG,1hPG,2hPG,FINS和HOMA-IR呈正相关(r=0.286~0.564,均P<0.05),与HOMA-β呈负相关(r=-0.391,P<0.01);网膜素-1与孕前BMI,孕24周前增重、FBG,1hPG,2hPG,FIN和HOMA-IR呈负相关(r=-0.619~-0.206,均P<0.05),与HOMA-β呈正相关(r=0.505,P<0.01);Lipasin与孕24周前增重、TG,FBG,1hPG,2hPG,FIN和HOMA-IR呈正相关(r=0.363~0.611,均P<0.01),与HOMA-β呈负相关(r=-0.496,P<0.01)。③孕24周前增重、HOMA-IR,人吻素、网膜素-1、Lipasin为GDM发生的独立影响因素。④孕早期人吻素、网膜素-1和Lipasin血清水平预测GDM发生风险的AUC分别为0.795,0.683和0.619。三者联合检测的AUC为0.827,高于以上单一指标检测(Z=-2.168,-2.509,-2.651,均P<0.05)。结论GDM患者孕早期人吻素和Lipasin血清水平升高,网膜素-1血清水平降低,人吻素、网膜素-1和Lipasin均与糖脂代谢异常、GDM发病有关,三者联合检测可用于GDM早期诊断。
Objective To investigate the value of the serum levels of human kisspeptin,omentin-1 and Lipasin in early pregnant women for early prediction of the risk of gestational diabetes mellitus(GDM).Methods A total of 256 pregnant women who received regular prenatal examination in the Fourth People’s Hospital of Langfang from March 2018 to March 2021 were selected and divided into GDM group(n=136)and non-GDM group(n=120)according to the results of oral glucose tolerance test(OGTT)in mid-pregnancy.General clinical data,serum levels of human kisspeptin,Omentin-1,Lipasin and adverse pregnancy outcomes in the first trimester were compared between the two groups.Results①Compared with the non-GDM group,the serum levels of human kisspeptin in early pregnancy(3.35±0.95 nmol/L vs 2.19±0.76 nmol/L)and Lipasin(3.29±0.43 ng/ml vs 1.07±0.06 ng/ml)in GDM group were higher(t=4.964,16.798,all P<0.01),and the serum level of Omentin-1(216.73±70.16 ng/ml vs 278.09±93.45 ng/ml)in early pregnancy was lower(t=3.326,P<0.05),the differences were statistically significant,respectively.②The serum level of human kisspeptin in early pregnancy were positively correlated with BMI before pregnancy,weight gain before 24 weeks of pregnancy,TG,FBG,1hPG,2hPG,FINS and HOMA-IR(r=0.286~0.564,all P<0.05),but negatively correlated with HOMA-β(r=-0.391,P<0.05).The serum level of Omentin-1 in early pregnancy was negatively correlated with BMI before pregnancy,weight gain before 24 weeks of pregnancy,FBG,1hPG,2hPG,FINS and HOMA-IR(r=-0.619~-0.206,all P<0.05),and positively correlated with HOMA-β(r=0.505,P<0.01).The serum level of Lipasin in early pregnancy was positively correlated with weight gain before 24 weeks of pregnancy,TG,FBG,1hPG,2hPG,FINS and HOMA-IR(r=0.363~0.611,all P<0.01),and negatively correlated with HOMA-β(r=-0.496,P<0.01).③Weight gain before 24 weeks of pregnancy,HOMA-IR,human kisspeptin,Omentin-1 and Lipasin were the independent influencing factors for the occurrence of GDM.④The AUC of human kisspeptin,omentin-1 and Lipasin in predicting the risk of GDM were 0.795,0.683 and 0.619,respectively.The AUC of the three indexes combined was 0.827,which higher than the above single indexes.Conclusion In the early pregnancy of GDM patients,the serum levels of human kisspeptin and Lipasin increased,while the levels of Omentin-1 decreased.kisspeptin,Omentin-1 and Lipasin were associated with abnormal glucose and lipid metabolism,the incidence of GDM,the combined detection of GDM can be used for early diagnosis of GDM.
作者
徐燕
李晶
XU Yan;LI Jing(Department of Obstetrics,the Fourth People’s Hospital of Langfang/Affiliated Hospital of Chengde Medical College,Hebei Langfang 065700,China)
出处
《现代检验医学杂志》
CAS
2022年第3期119-123,181,共6页
Journal of Modern Laboratory Medicine
