摘要
目的探讨人吻素1、脂肪酸结合蛋白质4(FABP4)与糖脂代谢指标的相关性及其对妊娠糖尿病(GDM)的早期诊断价值。方法选取2018年1月至2022年1月在河北大学附属医院产科门诊建卡的496例孕妇作为研究对象,根据是否发生GDM分为GDM组和正常组。比较两组孕妇的临床资料。采用Pearson相关分析GDM患者人吻素1、FABP4水平与糖脂代谢指标的相关性。采用多因素Logistic回归分析孕妇发生GDM的危险因素。绘制受试者工作特征(ROC)曲线分析人吻素1、FABP4单独及联合检测对GDM的诊断价值。结果两组孕妇孕前体质量指数(BMI)、孕24周增长体质量、稳态模型胰岛素抵抗指数(HOMA-IR)、稳态模型胰岛β细胞功能指数(HOMA-β)、空腹血糖(FBG)、口服葡萄糖耐量试验(OGTT)1 h血糖(1 hPG)、OGTT 2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、人吻素1、FABP4水平比较,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,GDM孕妇人吻素1水平与孕前BMI、HOMA-IR、FBG、OGTT 1 hPG、OGTT 2 hPG、HbA1c、TG、FINS水平均呈正相关(P<0.05),与HOMA-β呈负相关(P<0.05);GDM孕妇FABP4水平与孕24周增长体质量、HOMA-IR、TG、LDL-C、FINS水平均呈正相关(P<0.05),与高密度脂蛋白胆固醇(HDL-C)水平、HOMA-β均呈负相关(P<0.05)。多因素Logistic回归分析结果显示,孕24周增长体质量、HOMA-IR、HOMA-β、FBG、OGTT 1 hPG、OGTT 2 hPG、HbA1c、TG、FINS、人吻素1、FABP4水平升高是孕妇发生GDM的独立危险因素(P<0.05)。ROC曲线分析结果显示,人吻素1、FABP4联合诊断GDM的曲线下面积(AUC)为0.865,高于人吻素1、FABP4单独诊断GDM的AUC(Z=4.563、5.681,P<0.05)。结论人吻素1、FABP4对GDM的早期诊断具有重要意义,2项指标联合检测能够有效提高GDM的诊断率。
Objective To investigate the correlation between human kisspeptin 1,fatty acid binding protein 4(FABP4)and glucose and lipid metabolism indexes and their early diagnostic value for gestational diabetes mellitus(GDM).Methods A total of 496 pregnant women who registered in the Department of Obstetrics of the Affiliated Hospital of Hebei University from January 2018 to January 2022 were selected as the research objects.According to whether GDM occurred,they were divided into GDM group and normal group.The clinical data of the two groups were compared.Pearson correlation was used to analyze the correlation between the levels of human kisspeptin 1 and FABP4 and glucose and lipid metabolism indexes in GDM patients.Multivariate Logistic regression was used to analyze the risk factors of GDM in pregnant women.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of human kisspeptin 1 and FABP4 alone and in combination for GDM.Results Pre-pregnancy body mass index(BMI),gestational weight gain at 24 weeks,homeostrasis model insulin resistance index(HOMA-IR),homeostrasis model isletβcell function index(HOMA-β),fasting blood glucose(FBG),oral glucose tolerance test(OGTT)1 h blood glucose(1 hPG),OGTT 2 h blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),human kisspeptin 1 and FABP4 levels were compared between the two groups,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the level of human kisspeptin 1 in pregnant women with GDM was positively correlated with pre-pregnancy BMI,HOMA-IR,FBG,OGTT 1 hPG,OGTT 2 hPG,HbA1c,TG and FINS levels(P<0.05),and it was negatively correlated with HOMA-β(P<0.05).The level of FABP4 in GDM pregnant women was positively correlated with gestational weight gain at 24 weeks,HOMA-IR,TG,LDL-C and FINS levels(P<0.05),and it was negatively correlated with high-density lipoprotein cholesterol(HDL-C)level and HOMA-β(P<0.05).Multivariate Logistic regression analysis results showed that the increase of gestational weight gain at 24 weeks,HOMA-IR,HOMA-β,FBG,OGTT 1 hPG,OGTT 2 hPG,HbA1c,TG,FINS,human kisspeptin 1 and FABP4 levels were independent risk factors for GDM in pregnant women(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of the combination of human kisspeptin 1 and FABP4 in the diagnosis of GDM was 0.865,which was higher than that of human kisspeptin 1 or FABP4 alone(Z=4.563,5.681,P<0.05).Conclusion Human kisspeptin 1 and FABP4 are important for the early diagnosis of GDM,and the combined detection of the two indicators can effectively improve the diagnosis rate of GDM.
作者
赵海歌
梁淑新
赵雅堃
崔雯萱
蔺美霖
郑海亮
冯实
ZHAO Haige;LIANG Shuxin;ZHAO Yakun;CUI Wenxuan;LIN Meilin;ZHENG Hailiang;FENG Shi(Department of Clinical Laboratory,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China;Department of Obstetrics,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China;Department of Clinical Laboratory,Hebei Rongjun Hospital,Baoding,Hebei 071000,China)
出处
《检验医学与临床》
CAS
2024年第11期1595-1599,1605,共6页
Laboratory Medicine and Clinic
基金
2019年度河北大学附属医院院内基金项目(2019Q011)。
关键词
妊娠糖尿病
人吻素1
脂肪酸结合蛋白质4
糖脂代谢
胰岛素抵抗
gestational diabetes mellitus
human kisspeptin 1
fatty acid binding protein 4
glucose and lipid metabolism
insulin resistance
