血清铁蛋白、25-羟基维生素D、超敏C反应蛋白在妊娠早期检测对妊娠期糖尿病的预测价值  

Predictive value of serum ferritin,25-hydroxyvitamin D and high sensitivity C reactive protein in early pregnancy for gestational diabetes mellitus

作　　者：金莲华 马梓汶 沈双鱼 张宝仁[1] 毛美丽 JIN Lianhua;MA Ziwen;SHEN Shuangyu;ZHANG Baoren;MAO Meili(Department of Laboratory,Shanghai Pudong New Area Maternal and Child Health Hospital,Shanghai201206,China;Department of Obstetrics and Gynecology,Shanghai Pudong New Area Maternal and Child Health Hospital,Shanghai201206,China)

机构地区：[1]上海市浦东新区妇幼保健院检验科,上海201206 [2]上海市浦东新区妇幼保健院妇产科,上海201206

出　　处：《中国当代医药》2022年第15期19-22,F0003,共5页China Modern Medicine

基　　金：上海市浦东新区科技发展基金(PKJ2020-Y72)。

摘　　要：目的探讨妊娠早期血清铁蛋白(SF)、25-羟基维生素D[25-(OH)D]、超敏C反应蛋白(hs-CRP)检测在妊娠期糖尿病(GDM)预测中的应用价值。方法回顾性选取2020年1月至12月在浦东新区妇幼保健院产科门诊登记初诊的573例孕妇为研究对象,均于妊娠早期(孕12~16周)检测空腹血糖正常,再于孕24~28周时通过口服75 g葡萄糖耐量试验,诊断为GDM的产妇分为观察组(273例),非GDM产妇为对照组(300例)。分析两组产妇孕12~16周的SF、25-(OH)D、hs-CRP水平,采用logistic回归分析SF、25-(OH)D、hs-CRP对GDM的影响,并绘制ROC曲线,分析三者的预测价值。结果实验室检查结果中,两组的空腹血糖(FPG)比较,差异无统计学意义(P>0.05);观察组的SF、hs-CRP高于对照组,25-(OH)D低于对照组,差异有统计学意义(P<0.05)。logistic回归分析显示,SF、hs-CRP为GDM发生的危险因素(P<0.05,OR>1),25-(OH)D为保护因素(P<0.05,OR<1)。12~16周SF、25-(OH)D、hs-CRP的ROC曲线下面积分别为0.730、0.716、0.788,灵敏度分别为66.3%、71.4%、72.5%,特异度分别为69.0%、64.0%、77.3%,三者联合诊断的曲线下面积为0.818,灵敏度71.1%,特异度79.7%。结论在妊娠早期血清铁蛋白、25-(OH)D、hs-CRP联合检测对于GDM的发生有一定的预示价值,对GDM患者早发现、早预防以及控糖达标、改善妊娠结局具有一定的积极意义。Objective To determine the application value of serum ferritin(SF),25-hydroxyvitamin D[25-(OH)D]and high sensitivity C reactive protein(hs-CRP)in the prediction of gestational diabetes mellitus(GDM)in early pregnancy.Methods The retrospective selection of 573 pregnant women who registered for the first visit in the obstetric clinic of Pudong New Area Maternal and Child Health hospital from January 2020 to December 2020 were selected as the research objects.All of them were tested for normal fasting blood glucose in the first trimester(12-16 weeks of gestation),and then passed the oral 75 g glucose tolerance test at 24-28 weeks of gestation.Parturients diagnosed with GDM were divided into observation group(273 cases),and non-GDM parturients were as the control group(300 cases).The levels of SF,25-(OH)D,and hs-CRP in the two groups of parturients at 12-16 weeks of gestation were analyzed,and the effects of SF,25-(OH)D,and hs-CRP on GDM were analyzed with logistic regression,and ROC curves were drawn.The predictive value of SF,25-(OH)D,and hs-CRP was analyzed.Results There was no significant difference in fasting blood glucose(FPG)between the two groups(P>0.05).SF and hs-CRP in the observation group were higher than those in the control group,while 25-(OH)D was lower than those in the control group,the differences were statistically significant(P<0.05).Logistic regression analysis showed that SF and hs-CRP were risk factors for GDM(P<0.05,OR>1),and 25-(OH)D was protective factor(P<0.05,OR<1).The areas under the ROC curve of SF,25-(OH)D and hs-CRP at 12-16 weeks of gestation were 0.730,0.716 and 0.788,respectively,the sensitivity was 66.3%,71.4%and 72.5%,and the specificity was 69.0%,64.0%and 77.3%,respectively.The area under the curve of combined diagnosis of the SF,25-(OH)D and hs-CRP was 0.818,the sensitivity was 71.1%and the specificity was 79.7%.Conclusion The combined detection of serum ferritin,25-(OH)D and hs-CRP in early pregnancy has a certain predictive value for the occurrence of GDM,and has a certain pos

关 键 词：妊娠期糖尿病 25-羟基维生素D 血清铁蛋白 超敏C反应蛋白 联合检测 

分 类 号：R714.2[医药卫生—妇产科学]