摘要
目的研究妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血清胰高血糖素样肽1(glucagon-like peptide 1,GLP-1)及胎盘组织中胰岛素样生长因子1受体(insulin 1ike growth factor 1 receptor,IGF-1R)与新生儿结局的关系。方法收集产检和孕足月分娩单胎妊娠孕妇,通过妊娠24~28周75 g口服葡萄糖耐量试验(oral glucose tolerance test,OGTT),将其分为GDM组和非GDM组,比较两组体重指数(body mass index,BMI)、年龄、孕周、空腹血糖(fasting plasma glucose,FPG),服糖后1 h血糖(1 h fasting plasma glucose after taking sugar,FPG1)、服糖后2 h血糖(2 h fasting plasma glucose after taking sugar,FPG2)、IGF-1R、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、血清GLP-1情况。同时,探究GLP-1、IGF-1R与新生儿结局的关系以及GLP-1、IGF-1R两者的相关性。结果两组患者于孕前BMI、FPG、FPG1、FPG2、IGF-1R、HbA1c、血清GLP-1差异有统计学意义(P<0.05),但是在年龄、孕周差异无统计学意义(P>0.05)。GDM组中,不良新生儿结局50例(25.0%),非GDM组不良新生儿结局10例(5%),差异有统计学意义(χ~2=31.373,P<0.001)。GLP-1与不良新生儿结局负向影响关系[β=-0.141,OR=0.869(95%CI:0.821~0.919)];IGF与不良新生儿结局有正向影响关系[β=0.745,OR=2.107(95%CI:1.214~3.656)]。影响不良新生儿结局的独立危险因素是GDM和IGF-1R。GLP-1、IGF-1R呈负相关关系(r=-0.478,P<0.05)。结论妊娠期糖尿病患者血清GLP-1负向影响不良新生儿结局,而胎盘组织中IGF-1R正向影响不良新生儿结局。临床需加以注意。
Objective To study the relationship between serum glucagon-like peptide-1(GLP-1) and insulin-like growth factor 1 receptor(IGF-1R) in placental tissues and neonatal outcomes in patients with gestational diabetes. Methods Pregnant women undergoing pregnancy examination and women with full-term singleton pregnancy in our hospital were enrolled. They underwent 75 g OGTT examination at 24-28 weeks of pregnancy and were divided into GDM group and non-GDM group. Body mass index(BMI), age, gestational age, fasting plasma glucose(FPG), 1 h fasting plasma glucose after taking sugar(FPG1), 2 h fasting plasma glucose after taking sugar(FPG2), IGF-1R, glycosylated hemoglobin(HbA1c), and GLP-1 were compared between the two groups. Meanwhile, the relationship between GLP-1, IGF-1R and neonatal outcomes as well as the correlation between GLP-1 and IGF-1R was explored. Results There were significant differences in BMI, FPG, FPG1, FPG2, IGF-1R, HbA1c, and serum GLP-1 between two groups before pregnancy(P<0.05), but there was no difference in age and gestational age(P>0.05). In the GDM group, 50 cases(25.0%) had adverse neonatal outcomes, and 10 cases(5%) in the non-GDM group had adverse neonatal outcomes, suggesting significant differences(χ~2=31.373, P<0.001). GLP-1 had a negative impact on adverse neonatal outcomes [β=-0.141, OR=0.869(95%CI: 0.821-0.919)], and IGF had a positive impact on adverse neonatal outcomes[β=0.745, OR= 2.107(95%CI: 1.214-3.656)]. The independent risk factors affecting adverse neonatal outcomes were GDM and IGF-1R. There was a negative correlation between GLP-1 and IGF-1R(r=-0.478, P<0.05). Conclusion Serum GLP-1 in patients with gestational diabetes negatively affects adverse neonatal outcomes, while IGF-1R in placental tissues positively affects adverse neonatal outcomes, which warrants attention in clinical practice.
作者
邵婕
杨美芳
张秀
SHAO Jie;YANG Mei-fang;ZHANG Xiu(Department of Obstetrics,Jiangsu Shengze Hospital Affiliated to Nanjing Medical University,Suzhou 215000,China)
出处
《河北医科大学学报》
CAS
2022年第9期1042-1046,共5页
Journal of Hebei Medical University
基金
苏州市吴江区“科教兴卫”项目(wwk201813)。
