血浆氧化三甲胺水平与妊娠糖尿病的相关性  

Correlation of gestational diabetes mellitus with plasma TMAO

作　　者：乐江漫 李天园 谭美玉 王亚捷 周丽达 殳洁 武娇祥 孙寒晓[1] 宣彬彬[1] 蔡徐山[2] 盛慧明[1] LE Jiangman;LI Tianyuan;TAN Meiyu;WANG Yajie;ZHOU Lida;SHU Jie;WU Jiaoxiang;SUN Hanxiao;XUAN Binbin;CAI Xushan;SHENG Huiming(Department of Clinical Laboratory,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200050,China;Department of Clinical Laboratory,Maternal and Children Healthcare Hospital of Jiading,Shanghai 201821,China)

机构地区：[1]上海交通大学医学院附属同仁医院检验科,上海200050 [2]上海市嘉定区妇幼保健院检验科,上海201821

出　　处：《检验医学》2021年第8期795-799,共5页Laboratory Medicine

基　　金：上海市长宁区人才基金项目(YXMZK012);上海市长宁区检验科重点学科项目(20191001)。

摘　　要：目的探讨血浆氧化三甲胺(TMAO)水平与妊娠糖尿病(GDM)的相关性。方法选取孕24~28周时接受口服糖耐量实验(OGTT)检查的单胎妊娠孕妇272例,其中GDM患者178例(GDM组)、正常孕妇94例(正常妊娠组)。记录所有孕妇的一般资料,同时检测孕早期(孕周≤13周)血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(apo)A1、apo B100、丙氨酸氨基转移酶(ALT)、空腹血糖(FBG)以及孕中期和孕晚期的血浆TMAO水平。采用多因素Logistic回归分析评估GDM发生的危险因素。结果GDM组孕早期血清TG、FBG水平均高于正常妊娠组(P<0.05);而GDM组孕早期血清ALT、TC、HDL-C、LDL-C、apo A1、apo B100水平与正常妊娠组比较,差异均无统计学意义(P>0.05)。GDM组孕中期血浆TMAO水平显著高于正常妊娠组(P<0.05)。GDM组孕中期与孕晚期血浆TMAO水平差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,孕早期FBG、TG及孕中期TMAO水平升高是GDM发病的独立危险因素[比值比(OR)值分别为3.883、2.146、1.514,95%可信区间(CI)分别为1.805~8.353、1.245~3.702、1.079~2.125]。结论孕中期孕妇血浆TMAO水平与GDM的发病风险有关。Objective To investigate the correlation between plasma trimethylamine oxide(TMAO)and gestational diabetes mellitus(GDM).Methods Totally,272 singleton pregnant women were enrolled and determined for oral glucose tolerance test(OGTT)from 24 to 28 gestational weeks.There were 178 cases of GDM and 94 cases of healthy pregnant women(control group).The general data of all pregnant women were recorded.Serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein(apo)A1,apo B100,alanine aminotransferase(ALT)and fasting blood glucose(FBG)levels were determined during early pregnancy(gestational week≤13),and TMAO levels in the second and third trimesters of pregnancy were determined as well.Multiple Logistic regression analysis was used to assess the risk factors of GDM.Results The levels of TG and FBG in the early pregnancy in GDM group were higher than those in control group(P<0.05),and the levels of ALT,TC,HDL-C,LDL-C,apo A1 and apo B100 in GDM group had no statistical significance from those in control group(P>0.05).The level of TMAO in GDM group was higher than that in control group(P<0.05).There was no statistical significance in TMAO level between the second and third trimesters of pregnancy in GDM group(P>0.05).Multiple Logistic regression analysis showed that the increase of FBG[odds ratio(OR)=3.883,95%confidence interval(CI)1.805-8.353],TG(OR=2.146,95%CI 1.245-3.702)and TMAO(OR=1.514,95%CI 1.079-2.125)were independent risk factors for GDM.Conclusions Plasma TMAO levels in the second trimester are positively associated with the risk of GDM.

关 键 词：氧化三甲胺 肠道菌群代谢产物 妊娠糖尿病 危险因素 

分 类 号：R446.1[医药卫生—诊断学]