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妊娠期糖尿病孕妇脂联素的表达和意义 预览

Expression and Meaning of Adiponectin in Pregnant Women With Gestational Diabetes Mellitus
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摘要 目的 探讨脂联素(Adiponectin,APN) 对妊娠期糖尿病(Gestational diabetes mellitus,GDM)的早期预测价值和相关性.方法 选取2015 年10 月-2016 年9 月在福建省妇幼保健院产检的GDM 及正常孕妇各100 例.分别于孕早期(10 - 12 周)、孕中期(24 - 28 周) 和孕晚期(36 - 38 周) 检测孕妇血清APN、胰岛素及血糖.比较孕早、中、晚期APN 水平,探讨孕早期APN对GDM 的预测价值.结果 (1)GDM 组不同阶段APN 均低于对照组,而血糖、胰岛素、HOMA-IR 高于对照组(P 〈 0.05).(2)GDM 组孕中期APN 与OGTT1、OGTT2、FINS 和HOMAIR均呈负相关(r =-0.675、-0.346、-0.490、-0.398, P 〈 0.01);对照组血清APN 与其它指标无显著相关性.(3)孕早期血清APN预测GDM 曲线结果AUCROC 为0.900,95%CI 为0.855-0.945.当临界值为8.91 μg/ml 时,其诊断GDM 敏感性为93%,特异性为80%,阳性预测值为91.95%,阴性预测值为82.30%,Youden 指数为0.73.当孕早期APN 〈 8.91μg/ml 时,GDM 的发生风险增高.结论 孕期APN 水平与GDM 的发生相关,孕早期APN 预测GDM有一定的价值. Objective To explore the correlation and early prediction valuebetween APN and GDM. Methods From October 2015 to September 2016,100 GDM and 100 normal pregnancies were involved . Serum APN, insulinlevels and blood glucose were detected respectively in the first trimester (10to 12 weeks) , the second trimester (24 to 28 weeks) and the third trimester(36 to 38 weeks)of pregnancy. Serum APN level at different stages,evaluated predictive value of serum APN at the first trimester for GDMwere analyzed. Results (1)Serum APN of different stage of GDM groupwas lower than the control group, while glucose, FINS, HOMA IR werehigher than the control group (P 〈 0.05). (2)For GDM pregnancies, in thesecond trimester,was negatively correlated with OGTT1, OGTT2, FINS andHOMA-IR (r = -0.675, -0.346, -0.490, -0.398, P 〈 0.01).The control grouphad no significant correlation between serum APN and other indicators.3.In the first trimester , serum APN predict GDM curve AUCROC was 0.900,95%CI was 0.855-0.945.When the cut off value of APN was 8.91 μg/ml, the sensitivity specificity, positive predictive value, negative predictive valueand Youden index was 93%, 80%, 91.95%, 82.30% and 0.73 respectively.It significantly increased the risk of GDM when APN 〈 8.91 g/ml was firsttrimester. Conclusion Serum APN level was associated with GDM, and inthe first trimester has certain prediction value for GDM.
作者 罗金英 颜建英 陈水仙 林娟 廖秋萍 LUO Jinying1,YAN Jianying2,CHEN Shuixian1,LIN Juan1,LIAO Qiuping2(1 Department of Women Health Care, Fujian Provincial Maternity andChildren’s Hospital, Affiliated Hospital of Fujian Medical University, FuzhouFujian 350001,China; 2 Department of Gynaecology and Obstetrics)
出处 《中国卫生标准管理》 2018年第19期48-50,共3页
基金 福建省医学创新课题(2017-CX-11) 福建省卫生计生委青年科研课题(2015-1-18) 福建省临床重点专科(西医类别)建设项目(闽卫医政函2015593号)
关键词 妊娠期糖尿病 脂联素 血糖 预测 胰岛素 OGTT gestational diabetes mellitus adiponectin glucose evaluation Insulin oral glucose tolerance test
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