摘要
目的:探讨妊娠期糖尿病(GDM)患者血清可溶性CD14(sCD14)、toll样受体2(TLR2)水平与胰岛细胞功能、不良妊娠结局关系。方法:回顾性收集2020年1月—2022年6月本院收治的GDM患者113例为GDM组,产前检查正常孕妇96例为对照组,均检测血清sCD14、TLR2及空腹胰岛素(FINS)、空腹血糖(FPG)水平,并计算胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)。分析比较各组血清sCD14、TLR2、HOMA-IR、HOMA-β水平及妊娠结局;采用Pearson相关分析GDM患者血清sCD14、TLR2与胰岛细胞功能的关系,多因素logistic回归分析GDM患者妊娠结局影响因素。结果:GDM组血清sCD14、TLR2及FPG、FINS、HOMA-IR均高于对照组,HOMA-β低于对照组(均P<0.05)。Pearson相关分析显示,GDM患者血清sCD14与HOMA-IR呈正相关、与HOMA-β呈负相关,血清TLR2与HOMA-IR呈正相关、与HOMA-β呈负相关(均P<0.05)。GDM组不良妊娠结局总发生率(38.9%)高于对照组(16.7%)(P<0.05)。GDM患者妊娠结局不良者血清sCD14、TLR2水平均高于妊娠结局良好者(P<0.05)。多因素logistic回归分析显示,年龄≥30岁、孕前体质指数>28kg/m~2、存在不良孕产史、血糖控制不良及血清sCD14≥310.44ng/ml、TLR2≥17.14g/L均为影响GDM患者妊娠结局不良的危险因素(P<0.05)。结论:GDM患者血清sCD14、TLR2水平均异常升高,且二者水平与胰岛细胞功能、妊娠结局不良发生有关。
Objective:To explore the correlation between the serum soluble CD14(sCD14)and toll-like receptor 2(TLR2)levels of pregnant women with gestational diabetes mellitus(GDM)and their islet cell function and pregnancy outcomes.Methods:A total of 113pregnant women with GDM from January 2020to June 2022were selected in study group retrospectively,and 96normal pregnant women admitted for physical examination during the same period were selected in control group.The levels of serum sCD14,TLR2,fasting insulin(FINS)and fasting blood glucose(FPG)of the women in the two groups were detected,and the values of insulin resistance index(HOMA-IR)and islet beta cell function index(HOMA-β)of the women in the two groups were calculated.The levels of serum sCD14and TLR2,the values of HOMA-IR and HOMA-β,and the pregnancy outcomes of the women were analyzed and compared between the two groups.Pearson correlation was used to analyze the correlation between the serum sCD14and TLR2levels of the women with GDM and their islet cell function.Multivariate logistic regression was used to analyze the influencing factors of the pregnancy outcomes of the women with GDM.Results:The levels of serum sCD14,TLR2,FPG,and FINS,and the HOMA-IR value of the women in the study group were significantly higher than those of the women in the control group,but the HOMA-βvalue of the women in the study group was significantly lower(P<0.05).Pearson correlation analysis showed that the serum sCD14level of the women with GDM was positively correlated with their HOMA-IR value,and was negatively correlated with their HOMA-βvalue.The serum TLR2 level of the women with GDM was positively correlated with their HOMA-IR value,and was negatively correlated with their HOMA-βvalue(all P<0.05).The overall incidence of adverse pregnancy outcomes(38.9%)of the women in the study group was significantly higher than that(16.7%)of the women in the control group(P<0.05).The levels of serum sCD14and TLR2of the women with poor pregnancy outcomes in the study group were significantly higher than those of the women with normal pregnancy outcomes(P<0.05).Multivariate logistic regression analysis showed that the age≥30years old,the pre-pregnancy body mass index>28kg/m2,the adverse pregnancy history,the poor blood glucose control,and the levels of serum sCD14≥310.44ng/ml and TLR2≥17.14g/L of the women with GDM were all the risk factors of their adverse pregnancy outcomes(P<0.05).Conclusion:The levels of serum sCD14and TLR2of the women with GDM are increased abnormally,and both of which are closely related to the function of islet cells and the adverse pregnancy outcomes of these women.
作者
潘玉平
靳博
郭淼
杨俊英
PAN Yuping;JIN Bo;GUO Miao;YANG Junying(Nanyang Second People's Hospital,Nanyang,Henan Province,473000)
出处
《中国计划生育学杂志》
2023年第7期1722-1726,共5页
Chinese Journal of Family Planning
