孕中期血清载脂蛋白CⅢ、Apelin、Chemerin水平及对妊娠期糖尿病诊断和不良妊娠结局的影响  

Serum Levels of Apolipoprotein CⅢ,Apelin and Chemerin in the Second Trimester of Pregnancy and Their Effects on the Diagnosis and Poor Pregnancy Outcomes of Patients with Gestational Diabetes Mellitus

作　　者：余红琴 于静 张晓琳 YU Hong-qin;YU Jing;ZHANG Xiao-lin(Department of Obstetrics and Gynecology,Liaoyou Baoshihua Hospital of Panjin City,Panjin,Liaoning 124010,China)

机构地区：[1]盘锦辽油宝石花医院妇产科,辽宁盘锦124010

出　　处：《临床误诊误治》2022年第2期82-86,共5页Clinical Misdiagnosis & Mistherapy

基　　金：辽宁省医学科技攻关计划项目(2017-3917)。

摘　　要：目的观察孕中期血清载脂蛋白CⅢ(apo CⅢ)、Apelin、Chemerin水平,并探讨三者对妊娠期糖尿病(GDM)的诊断价值及与妊娠不良结局的关系。方法选取2017年8月—2019年8月经筛查确诊为GDM的87例孕妇作为观察组,另选取同期筛查正常的孕妇80例作为对照组。比较两组血清apo CⅢ、Apelin、Chemerin水平,三者之间的相关性采用Pearson相关分析;受试者工作特征(ROC)曲线分析三者对GDM的诊断价值;影响GDM不良妊娠结局的危险因素采用多因素Logistic回归分析。结果观察组血清apo CⅢ、Apelin、Chemerin水平均高于对照组(P<0.01)。血清apo CⅢ、Apelin、Chemerin之间均呈正相关性(P<0.01)。血清apo CⅢ、Apelin、Chemerin及三者联合诊断GDM的ROC曲线下面积分别为0.841、0.718、0.785及0.861,三者联合诊断的敏感度为63.2%,特异度为93.7%。不良妊娠结局GDM患者血清apo CⅢ、Apelin、Chemerin水平均高于正常妊娠结局GDM患者(P<0.05);孕中期血清apo CⅢ、Apelin、Chemerin水平升高均是影响GDM患者不良妊娠结局的独立危险因素(P<0.05,P<0.01)。结论孕中期GDM血清apo CⅢ、Apelin、Chemerin均呈高表达,三者联合对GDM具有较高的诊断价值,且是影响GDM患者不良妊娠结局的独立危险因素。Objective To observe serum levels of apolipoprotein CⅢ(apo CⅢ),Apelin and Chemerin in the second trimester of pregnancy,and to explore their diagnostic values for patients with gestational diabetes mellitus(GDM)and their correlations with poor pregnancy outcomes.Methods A total of 87 patients with GDM diagnosed by screening between August 2017 and August 2019 were selected as observation group,and other 80 healthy pregnant women undergoing screening at the same period were selected as control group.Serum levels of apo CⅢ,Apelin and Chemerin were compared between two groups,and Pearson correlation analysis was used to analyze correlations among the three indexes,and then receiver operating characteristic(ROC)curve was used to analyze diagnostic values of the three indexes for GDM.Risk factors affecting adverse pregnancy outcome of GDM patients were analyzed by multivariate Logistic regression.Results Serum levels of apo CⅢ,Apelin and Chemerin in observation group were significantly higher than those in control group(P<0.01).There were positive correlations among serum apo CⅢ,Apelin and Chemerin(P<0.01).The areas under the ROC curve of serum apo CⅢ,Apelin,Chemerin and their combined diagnosis of GDM were 0.841,0.718,0.785 and 0.861 respectively.The sensitivity and specificity of their combined diagnosis were 63.2%and 93.7%respectively.Serum levels of apo CⅢ,Apelin and Chemerin in GDM patients with adverse pregnancy outcomes were significantly higher than those in GDM patients with normal pregnancy outcome(P<0.05).The increased levels of serum apo CⅢ,Apelin and Chemerin in the second trimester of pregnancy were independent risk factors affecting adverse pregnancy outcomes of GDM patients(P<0.05,P<0.01).Conclusion Apo CⅢ,Apelin and Chemerin are highly expressed in the serum of GDM women in the second trimester of pregnancy,and combined detection of the three indexes has good diagnostic value for GDM,and they are independent risk factors for adverse pregnancy outcomes of GDM patients.

关 键 词：糖尿病 妊娠 载脂蛋白CⅢ APELIN CHEMERIN 妊娠结局 诊断 危险因素 

分 类 号：R714.256[医药卫生—妇产科学]