妊娠初期Th细胞因子与妊娠期糖尿病发生的相关性及对产后糖代谢异常的预测效能研究  

Correlation between T helper cell cytokines in early pregnancy and the occurrence of gestational diabetes mellitus and the prediction of abnormal postpartum glucose metabolism

作　　者：蒋燕红 董娟 石慧芬 JIANG Yanhong;DONG Juan;SHI Huifen(Health Branch,Zhejiang Zhuji Maternal and Child Health Care Hospital,Zhuji311800,Zhejiang,China;Department of Obstetrics and Gynecology,Zhejiang Shaoxing Maternal and Child Health Care Hospital,Shaoxing 312000,Zhejiang,China)

机构地区：[1]浙江省诸暨市妇幼保健院保健科,浙江诸暨311800 [2]浙江省绍兴市妇幼保健院妇产科,浙江绍兴312000

出　　处：《中国性科学》2021年第11期107-110,共4页Chinese Journal of Human Sexuality

摘　　要：目的分析妊娠初期辅助型T细胞(Th细胞)因子与妊娠期糖尿病发生的相关性及对产后糖代谢异常的预测效能。方法选取2019年1月至2021年1月在浙江省诸暨市妇幼保健院建档行规律产检、分娩的238例孕妇作为研究对象。在妊娠初期检测血清Th1细胞因子及Th2细胞因子,根据妊娠24~28周行75g葡萄糖耐量试验(OGTT)结果分为妊娠期糖尿病组(n=42)和对照组(n=196),比较两组妊娠初期Th细胞因子水平及其比值,通过受试者工作特征(ROC)曲线下面积(AUC)评价妊娠初期Th细胞因子对产后糖代谢异常的预测效能。结果妊娠期糖尿病组妊娠初期血清肿瘤坏死因子-α(TNF-α)水平高于对照组,白介素-10(IL-10)水平低于对照组,TNF-α/IL-4、IL-2/IL-10、γ-IFN/IL-10、TNF-α/IL-10均大于对照组,差异具有统计学意义(P<0.05);妊娠期糖尿病组妊娠24~28周胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)水平均高于对照组,差异具有统计学意义(P<0.05);经多因素Logistic回归分析,TNF-α、IL-10和TNF-α/IL-10均是妊娠期糖尿病发生的独立预测因素(P<0.05);经Pearson相关性分析,妊娠期糖尿病患者妊娠初期TNF-α/IL-10与妊娠24~28周HOMA-IR、HOMA-β均呈正相关(P<0.05);经ROC曲线分析,妊娠初期TNF-α/IL-10预测妊娠期糖尿病患者产后糖代谢异常的AUC为0.912。结论妊娠初期TNF-α/IL-10增大与妊娠期糖尿病发生的关系密切,对产后糖代谢异常具有较好的预测效能,可能成为早期筛查妊娠期糖尿病的重要指标。Objective To analyze the correlation between T helper cell(Th cell) cytokines in early pregnancy and the occurrence of gestational diabetes mellitus(GDM) and its predictive effect on postpartum glucose metabolism abnormalities. Methods From January 2019 to January 2021, 238 pregnant women who had regular labor check-up and delivery in Zhejiang Zhuji Maternal and Child Health Care Hospital were selected as the research objects. Serum Th1 cytokines and Th2 cytokines were detected at the beginning of gestation. According to the results of 75 g glucose tolerance test(OGTT) at 24 to 28 weeks of gestation, the two groups were divided into gestational diabetes group(n=42) and control group(n=196). The levels and ratios of Th cytokines in the two groups at the beginning of gestation were compared. The area under receiver-operating characteristic(ROC) curve(AUC) was used to evaluate the predictive efficacy of Th cytokines in early pregnancy for postpartum glucose metabolism abnormalities. Results The level of serum tumor necrosis factor-α(TNF-α) in gestational diabetes group was higher than that in control group, interleukin-10(IL-10) was lower than that in control group, and the levels of TNF-α/IL-4, IL-2/IL-10, γ-IFN/IL-10 and TNF-α/IL-10 were higher than those in control group(P<0.05). The levels of insulin resistance index(HOMA-IR) and islet β cell function index(HOMA-β) in GDM group were higher than those in control group at 24 to 28 weeks of gestation(P<0.05). Multivariate Logistic regression analysis showed that TNF-α, IL-10 and TNF-α/IL-10 were independent predictors of gestational diabetes(P<0.05). Pearson correlation analysis showed that TNF-α/IL-10 was positively correlated with HOMA-IR and HOMA-β at 24-28 weeks of gestation in gestational diabetes patients(P<0.05). ROC curve analysis showed that the AUC of TNF-α/IL-10 in early pregnancy predicting abnormal glucose metabolism in gestational diabetes was 0.912. Conclusions The increase of TNF-α/IL-10 in early pregnancy is closely related to the occu

关 键 词：妊娠期糖尿病 妊娠初期 TH细胞因子 胰岛素抵抗 产后糖代谢异常 

分 类 号：R711[医药卫生—妇产科学]