载脂蛋白BA1比值联合HOMA-IR指数对高危型孕妇妊娠期糖尿病及临床结局的预测价值  

Predictive value of apolipoprotein BA1 ratio combined with HOMA-IR index in gestational diabetes mellitus and clinical outcomes in high-risk pregnant women

作　　者：宋斌 蒋璐频 解晓平 袁艺萍 SONG Bin;JIANG Lupin;XIE Xiaoping;YUAN Yiping(Department of Obstetrics and Gynecology,The First Af.liated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院妇产科,重庆400038 [2]中国人民解放军陆军特色医学中心妇产科

出　　处：《中国妇产科临床杂志》2020年第5期495-498,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：重庆市科技计划项目(2015SHMSZX120065)。

摘　　要：目的探究载脂蛋白B(ApoB)/载脂蛋A1(ApoA1)比值联合胰岛素抵抗指数(HOMA-IR)对高危型孕妇妊娠期糖尿病(GDM)及临床结局的预测价值。方法回顾性分析2017年2月至2018年10月陆军军医大学第一附属医院妇产科208例高危型孕妇临床资料,根据其GDM发生情况分为GDM组与非GDM组,并纳入89例同期入院产检的健康孕妇作为对照组。使用受试者工作特征曲线(ROC曲线)评估ApoB/ApoA1、HOMA-IR及其联合检测对高危型孕妇GDM及不良临床结局的预测价值。结果三组年龄、孕前BMI、孕次及ApoB/ApoA1、HOMA-IR比较,均为GDM组>非GDM组>对照组(P<0.05);ApoB/ApoA1、HOMAIR对高危型孕妇GDM均有较高预测价值(P<0.05),其cut-off值分别为0.745、3.595,且联合检测预测价值最高(P<0.05)。临床结局不良组年龄、孕前BMI、孕次及ApoB/ApoA1、HOMA-IR均高于临床结局良好组(P<0.05);ApoB/ApoA1、HOMA-IR对高危型孕妇不良临床结局均有较高预测价值(P<0.05),其cut-off值分别为0.795、4.045,且联合检测预测价值最高(P<0.05)。结论ApoB/ApoA1与HOMA-IR联合检测在预测高危型孕妇发生GDM及不良临床结局中能发挥重要作用,临床应用价值高。Objective To investigate the predictive value of apolipoprotein B(ApoB)/apolipoprotein A1(ApoA1)ratio combined with insulin resistance index(HOMA-IR)in gestational diabetes mellitus(GDM)and clinical outcomes of high-risk pregnant women.Methods The clinical data of 208 high-risk pregnant women in Department of Obstetrics and Gynecology of the First Affiliated Hospital of Army Medical University from February 2017 to October 2018 were retrospectively analyzed.According to the occurrence of GDM,they were divided into GDM group and nonGDM group,and 89 healthy pregnant women admitted to the hospital for production inspection at the same period were included as control group.The receiver operating characteristic curve(ROC curve)was used to evaluate the predictive value of ApoB/ApoA1,HOMA-IR and their combined detection on GDM and poor clinical outcomes in high-risk pregnant women.Results The age,BMI before pregnancy,gravidity,ApoB/ApoA1 and HOMA-IR in the three groups all showed GDM group>non-GDM group>control group(P<0.05).The ApoB/ApoA1 and HOMA-IR had higher predictive value on GDM in high-risk pregnant women(P<0.05),and their cut-off values were 0.745 and 3.595 respectively,and the combined detection had the highest predictive value(P<0.05).The age,BMI before pregnancy,gravidity,and ApoB/ApoA1 and HOMA-IR in poor clinical outcome group were higher than those in good clinical outcome group(P<0.05).The ApoB/ApoA1 and HOMA-IR had higher predictive value on poor clinical outcomes in high-risk pregnant women(P<0.05),and their cut-off values were 0.795 and 4.045 respectively,and the combined detection had the highest predictive value(P<0.05).Conclusion The combined detection of ApoB/ApoA1 and HOMA-IR can play an important role in predicting GDM and poor clinical outcomes in high-risk pregnant women,with high clinical application value.

关 键 词：妊娠期糖尿病 高危型孕妇 ApoB/ApoA1 HOMA-IR 临床结局 

分 类 号：R714.256[医药卫生—妇产科学]