妊娠13~17周血清GLP-1、Nesfatin-1、PAPP-A与妊娠糖尿病的相关性  

Correlation between serum GLP-1, Nesfatin-1, PAPP-A and gestational diabetes mellitus at 13 to 17 weeks of gestation

作　　者：封伟[1] 危丽华 李冬霞[1] 郑秋梅 张新 FENG Wei;WEI Lihua;LI Dongxia;ZHENG Qiumei;ZHANG Xin(Laboratory Department,the Second People's Hospital of Hengshui,Hengshui 053000,Hebei,China;Department of Obstet-rics,the Second People's Hospital of Hengshui,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市第二人民医院检验科,河北衡水053000 [2]衡水市第二人民医院产一科,河北衡水053000

出　　处：《中国性科学》2022年第1期109-112,共4页Chinese Journal of Human Sexuality

基　　金：衡水市科技计划项目(2019014004Z)。

摘　　要：目的探讨血清胰高血糖素样肽-1(GLP-1)、摄食抑制因子1(Nesfatin-1)及妊娠相关血浆蛋白(PAPP-A)与妊娠糖尿病(GDM)的相关性。方法将2016年1月至2019年12月首次就诊于衡水市第二人民医院的12例GDM患者纳入GDM组;将同期年龄、孕周与GDM组相当的120例正常孕妇纳入为对照组。采集两组妊娠13~17周的血清标本,检测实验室相关参数;采用酶联免疫吸附试验(ELISA)法检测并比较两组血清GLP-1、Nesfatin-1及PAPP-A水平。采用Pearson检验进行相关性分析,采用Logistic回归法确认影响GDM发生的危险因素,并采用受试者工作特征(ROC)曲线分析其对GDM发生的预测价值。结果 GDM组的空腹血糖(FPG)、糖负荷后1h血糖(1hPG)、2h血糖(2hPG)、糖化血红蛋白(HbA1c)、稳态模型评估胰岛素抵抗指数(HOMA-IR)及新生儿体重显著高于对照组,而空腹胰岛素(FINS)、血清GLP-1、Nesfatin-1及PAPP-A水平则显著低于对照组(P<0.05)。Pearson检验结果显示,血清GLP-1、Nesfatin-1、PAPP-A与FPG、1hPG、2hPG、HbA1c、HOMA-IR呈负相关,而与FINS呈正相关;GLP-1与Nesfatin-1呈正相关。Logistic回归发现血清GLP-1、Nesfatin-1及PAPP-A均是影响GDM发生的独立危险因素。ROC曲线显示,血清GLP-1的ROC曲线下面积(AUC)为0.871,灵敏度为81.2%,特异度为83.5%;血清Nesfatin-1的AUC为0.822,灵敏度为76.7%,特异度为78.3%;血清PAPP-A的AUC为0.747,灵敏度为71.4%,特异度为70.8%。结论血清GLP-1、Nesfatin-1、PAPP-A与妊娠期GDM发生密切相关,可作为预测GDM发生的影响因素。Objective To investigate the relationship between serum GLP-1, Nesfatin-1, PAPP-A and GDM. Methods 12 GDM patients who first visited the Second People′s Hospital of Hengshui from January 2016 to December 2019 were included in the GDM group. 120 normal pregnant women with the same age and gestational age as the GDM group were selected as the control group. Serum samples from 13 to 17 weeks of gestation of both groups were collected to detect laboratory parameters. The levels of GLP-1, Nesfatin-1 and PAPP-A in serum of the two groups were detected and compared by enzyma-linked immunosorbent assay(ELISA). Pearson test was used for correlation analysis, Logistic regression method was used to identify risk factors affecting the occurrence of GDM, and receiver operating characteristic(ROC) curve was used to analyze its predictive value for the occurrence of GDM. Results Fasting blood glucose(FPG), 1 h blood glucose(1 hPG), 2 h blood glucose(2 hPG), HbA1 c, homeostasis model assessed insulin resistance index(HOMA-IR) and neonatal weight in GDM group were significantly higher than those in control group. Fasting insulin(FINS), serum GLP-1, Nesfatin-1 and PAPP-A levels were significantly lower than those in control group(P<0.05). Pearson test showed that serum GLP-1, Nesfatin-1 and PAPP-A were negatively correlated with FPG, 1 hPG, 2 hPG, HbA1 c and HOMA-IR, but positively correlated with FINS. GLP-1 was positively correlated with Nesfatin-1. Logistic regression showed that serum GLP-1, Nesfatin-1 and PAPP-A were independent risk factors affecting the occurrence of GDM. The area under ROC curve(AUC) of serum GLP-1 was 0.871, the sensitivity was 81.2%, and the specificity was 83.5%. The AUC of Nesfatin-1 was 0.822, the sensitivity was 76.7%, and the specificity was 78.3%. The AUC of serum PAPP-A was 0.747, the sensitivity was 71.4%, and the specificity was 70.8%. Conclusions Serum GLP-1, Nesfatin-1 and PAPP-A are closely related to the occurrence of GDM during pregnancy, which can be used as new influencing factors to pr

关 键 词：胰高血糖素样肽-1 摄食抑制因子1 妊娠相关血浆蛋白 

分 类 号：R714[医药卫生—妇产科学]