妊娠期糖尿病患者肠道菌群相关代谢产物、SF、SOCS-3变化及其对母婴不良结局的预测价值  

Changes of Intestinal Flora-related Metabolites,SF,SOCS-3 in Gestational Diabetes Mellitus and Their Predictive Value for Adverse Maternal and Infant Outcomes

作　　者：傅小青 李明 刘清秀 文丹 FU Xiaoqing;LI Ming;LIU Qingxiu;WEN Dan(Department of Obstetrics,Kaizhou District People′s Hospital,Chongqing 405400,China)

机构地区：[1]重庆市开州区人民医院产科,重庆405400

出　　处：《医学综述》2022年第11期2255-2259,2265,共6页Medical Recapitulate

基　　金：重庆市开州区第四批科技指导性计划项目(开科发[2018]30号(01))。

摘　　要：目的探讨妊娠期糖尿病(GDM)患者肠道菌群相关代谢产物[氧化三甲胺(TMAO)]、血清铁蛋白(SF)、细胞因子信号转导抑制因子3(SOCS-3)变化及其对母婴不良结局的预测价值。方法选取2018年7月至2020年10月重庆市开州区人民医院收治的80例GDM孕妇作为观察组,选择同期80例正常妊娠孕妇作为对照组,所有受试者从妊娠开始均在本院进行产检。比较两组孕早期血TMAO、SF、SOCS-3和稳态模型评估的胰岛素抵抗指数(HOMA-IR)水平;采用Pearson检验分析观察组孕早期TMAO、SF、SOCS-3、IR之间的相关性;绘制受试者工作特征曲线(ROC曲线)分析所有受试者孕早期血TMAO、SF和SOCS-3对GDM的预测价值。收集观察组母婴结局并分为母婴不良结局组和母婴良好结局组,对比两组确诊期血TMAO、SF和SOCS-3的水平,绘制ROC曲线分析确诊期TMAO、SF和SOCS-3对GDM母婴不良结局的预测价值。结果观察组孕早期血TMAO低于对照组[(11.5±2.2)μmol/L比(16.4±3.8)μmol/L](P<0.01),而SF、SOCS-3和HOMA-IR均高于对照组[(46±6)μg/L比(29±4)μg/L、(76±8)ng/L比(34±5)ng/L、(14.2±2.8)mU/L比(9.9±1.5)mU/L](均P<0.01)。Pearson相关分析结果显示,观察组孕早期TMAO与HOMA-IR呈明显负相关(r=-0.794,P=0.006),SF、SOCS-3与HOMA-IR呈明显正相关(r=0.682,P=0.011;r=0.721,P=0.009);TMAO与SF、SOCS-3呈明显负相关(r=-0.815,P=0.001;r=-0.847,P=0.001)。孕早期TMAO预测GDM的灵敏度和特异度分别为66.1%、71.9%,SF分别为64.2%、70.1%,SOCS-3分别为65.4%、70.4%,三者联合预测的灵敏度和特异度分别为77.5%、86.4%。母婴不良结局组确诊期血TMAO低于母婴良好结局组[(5.4±1.1)μmol/L比(7.6±2.1)μmol/L](P<0.01),SF和SOCS-3高于母婴良好结局组[(55±8)μg/L比(50±5)μg/L、(83±10)ng/L比(78±8)ng/L](P<0.05或P<0.01)。确诊期TMAO预测母婴不良结局的灵敏度和特异度分别为70.5%、65.4%,SF分别为71.7%、64.2%,SOCS-3分别为69.8%、63.5%,三者联合预测的灵敏度和特异Objective To investigate the changes of intestinal flora-related metabolites[trimethylamine oxide(TMAO)],serum ferritin(SF)and suppressor of cytokine signaling-3(SOCS-3)of gestational diabetes melltius(GDM)patients,and analyze their predictive value in the adverse maternal and infant outcomes.Methods A total of 80 pregnant women with GDM(observation group)and 80 pregnant women with normal pregnancy(control group)in Kaizhou District People′s Hospital from Jul.2018 to Oct.2020 were included.All the research objects were examined in this hospital from the beginning of pregnancy.The changes in blood TMAO,SF,SOCS-3 and homeostasis model assessment-insulin resistance(HOMA-IR)of the two groups were compared at early pregnancy;Pearson test was used to analyze the correlation between TMAO,SF,SOCS-3 and HOMA-IR in the observation group during early pregnancy;receiver operating characteristic curve(ROC curve)was drawn to analyze the predictive value of blood TMAO,SF and SOCS-3 for GDM in all subjects during early pregnancy.The maternal and infant outcomes of the observation group were collected,and the observation group was further divided into a poor maternal and infant outcome group and a good maternal and infant outcome group accordingly.Serum TMAO,SF and CSS-3 levels were compared between the two groups at the diagnosis stage,and ROC curves were drawn to analyze the predictive value of TMAO,SF and CSS-3 in the diagnosis stage for adverse GDM maternal and infant outcomes.Results Blood TMAO in the observation group in early pregnancy was lower than that in the control group[(11.5±2.2)μmol/L vs(16.4±3.8)μmol/L](P<0.01).SF,SOCS-3 and HOMA-IR were higher than those in the control group[(46±6)μg/L vs(29±4)μg/L,(76±8)ng/L vs(34±5)ng/L,(14.2±2.8)mU/L vs(9.9±1.5)mU/L](all P<0.01).Pearson analysis results showed that at early pregnancy in the observation group,TMAO was negatively correlated with HOMA-IR(r=-0.794,P=0.006),SF and SOCS-3 was positively correlated with HOMA-IR(r=0.682,P=0.011;r=0.721,P=0.009);TMAO was n

关 键 词：妊娠期糖尿病 肠道菌群相关代谢产物 铁蛋白 细胞因子信号转导抑制因子3 母婴结局 

分 类 号：R714.256[医药卫生—妇产科学]