摘要
目的探讨血清谷胱甘肽过氧化物酶(GSH-PX)、脂质过氧化物(Lpo)水平与妊娠期糖尿病(GDM)及其糖脂代谢异常、胰岛素抵抗和母婴结局的关系。方法选择2020年6月至2022年6月重庆大学附属黔江医院收治的120例GDM病人(GDM组)和同期收治的120例糖耐量正常的孕产妇(对照组)。检测血清GSH-Px、Lpo水平以及糖脂代谢、胰岛素抵抗指标,追踪母婴结局。Pearson分析GSH-Px、Lpo与糖脂代谢、胰岛素抵抗之间相关性,多因素logistic回归分析GDM母婴结局不良的因素。结果GDM组血清GSH-Px水平[(21.05±3.46)U/g比(30.42±5.09)U/g]低于对照组(P<0.05),Lpo水平[(15.95±3.17)μmol/L比(10.61±2.33)μmol/L]高于对照组(P<0.05)。GDM病人血清GSH-Px水平与总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)呈负相关(P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈正相关(P<0.05);Lpo水平与TC、TG、LDL-C、FPG、FINS、HOMA-IR呈正相关(P<0.05),与HDL-C呈负相关(P<0.05)。120例GDM病人中45例发生母婴结局不良,母婴结局不良组血清GSH-Px水平低于母婴结局良好组(P<0.05),Lpo水平高于母婴结局良好组(P<0.05)。多因素logistic回归分析结果显示年龄、HOMA-IR、Lpo是GDM病人母婴结局不良的危险因素(P<0.05),GSH-Px是GDM病人母婴结局不良的保护因素(P<0.05)。结论GDM病人血清GSH-Px水平降低,Lpo水平增高,且与糖脂代谢紊乱、胰岛素抵抗以及母婴结局不良有关,检测血清GSH-Px、Lpo水平有助于评估GDM胰岛素抵抗状态和母婴结局风险。
Objective To investigate the relationship between serum glutathione peroxidase(GSH-PX)and lipid peroxidase(Lpo)levels and gestational diabetes mellitus(GDM),abnormal glucose and lipid metabolism,insulin resistance and maternal and infant outcomes.Methods A total of 120 GDM patients admitted to the Qianjiang Hospital Affiliated to Chongqing University from June 2020 to June 2022(GDM group)and 120 pregnant women with normal glucose tolerance admitted during the same period(control group)were selected.Serum GSH-Px and Lpo levels,glucose and lipid metabolism,insulin resistance indexes were detected,and maternal and infant outcomes were tracked.The correlation between GSH-Px,Lpo,glucose and lipid metabolism and insulin resistance were analyzed by Pearson method,and the factors of adverse outcomes of maternal and infant GDM were analyzed by multivariate logistic regression.Results The serum GSH-Px level[(21.05±3.46)U/g vs.(30.42±5.09)U/g]in GDM group was lower than that in control group(P<0.05),and the serum Lpo level[(15.95±3.17)μmol/L vs.(10.61±2.33)μmol/L]in GDM group was higher than that in control group(P<0.05).Serum GSH-Px level in GDM patients was negatively correlated with total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),fasting insulin(FINS)and insulin resistance index(HOMA-IR)(P<0.05).It was positively correlated with high density lipoprotein cholesterol(HDL-C)(P<0.05).The level of Lpo was positively correlated with TC,TG,LDL-C,FPG,FINS and HOMA-IR(P<0.05),and negatively correlated with HDL-C(P<0.05).Among the 120 GDM patients,45 cases had poor maternal and infant outcomes.The serum GSH-Px level in the poor maternal and infant outcome group was lower than that in the good maternal and infant outcome group(P<0.05),and the Lpo level was higher than that in the good maternal and infant outcome group(P<0.05).Multivariate logistic regression analysis showed that age,HOMA-IR and Lpo were risk factors for adverse maternal and infant outcomes in GDM patients(P<0.05),and GSH-Px was protective factor for adverse maternal and infant outcomes in GDM patients(P<0.05).Conclusions Serum GSH-Px level is decreased and Lpo level is increased in patients with GDM,which is associated with the disorder of glucose and lipid metabolism,insulin resistance and poor maternal and infant outcomes.Detection of serum GSHPx and Lpo levels is helpful to evaluate the status of GDM insulin resistance and the risk of maternal and infant outcomes.
作者
白玲
赵琴
BAI Ling;ZHAO Qin(Department of Obstetrics,Qianjiang Hospital Affiliated to Chongqing University,Chongqing 409000,China)
出处
《安徽医药》
CAS
2024年第11期2226-2230,共5页
Anhui Medical and Pharmaceutical Journal
