孕早期妇女血清人吻素、网膜素-1和Lipasin水平检测对早期预测妊娠期糖尿病发生风险的价值  

Value of Serum Human Kisspeptin,Omentin-1 and Lipasin Levels in Early Pregnant Women for Early Prediction of the Risk of Gestational Diabetes Mellitus

作　　者：徐燕 李晶 XU Yan;LI Jing(Department of Obstetrics,the Fourth People’s Hospital of Langfang/Affiliated Hospital of Chengde Medical College,Hebei Langfang 065700,China)

机构地区：[1]廊坊市第四人民医院/承德医学院附属医院产科,河北廊坊065700

出　　处：《现代检验医学杂志》2022年第3期119-123,181,共6页Journal of Modern Laboratory Medicine

摘　　要：目的探讨孕早期妇女血清人吻素(human kisspeptin)、网膜素-1(omentin-1)和Lipasin水平检测对早期预测妊娠糖尿病(gestational diabetes mellitus,GDM)发生风险的价值。方法选取2018年3月~2021年3月廊坊市第四人民医院接受定期产前检查的孕妇256例,根据孕中期口服葡萄糖耐量实验(OGTT)检查结果分为GDM组(n=136)和非GDM组(n=120)。比较两组一般临床资料、孕早期人吻素、网膜素-1和Lipasin血清水平。结果①与非GDM组比较,GDM组孕早期人吻素(3.35±0.95 nmol/L vs 2.19±0.76 nmol/L),Lipasin(3.29±0.43 ng/ml vs 1.07±0.06 ng/ml)血清水平增高(t=4.964,16.798,均P<0.01),孕早期网膜素-1(216.73±70.16 ng/ml vs 278.09±93.45 ng/ml)血清水平降低(t=3.326,P<0.05),差异均有统计学意义。②孕早期人吻素血清水平与孕前BMI,孕24周前增重、TG,FBG,1hPG,2hPG,FINS和HOMA-IR呈正相关(r=0.286~0.564,均P<0.05),与HOMA-β呈负相关(r=-0.391,P<0.01);网膜素-1与孕前BMI,孕24周前增重、FBG,1hPG,2hPG,FIN和HOMA-IR呈负相关(r=-0.619~-0.206,均P<0.05),与HOMA-β呈正相关(r=0.505,P<0.01);Lipasin与孕24周前增重、TG,FBG,1hPG,2hPG,FIN和HOMA-IR呈正相关(r=0.363~0.611,均P<0.01),与HOMA-β呈负相关(r=-0.496,P<0.01)。③孕24周前增重、HOMA-IR,人吻素、网膜素-1、Lipasin为GDM发生的独立影响因素。④孕早期人吻素、网膜素-1和Lipasin血清水平预测GDM发生风险的AUC分别为0.795,0.683和0.619。三者联合检测的AUC为0.827,高于以上单一指标检测(Z=-2.168,-2.509,-2.651,均P<0.05)。结论GDM患者孕早期人吻素和Lipasin血清水平升高,网膜素-1血清水平降低,人吻素、网膜素-1和Lipasin均与糖脂代谢异常、GDM发病有关,三者联合检测可用于GDM早期诊断。Objective To investigate the value of the serum levels of human kisspeptin,omentin-1 and Lipasin in early pregnant women for early prediction of the risk of gestational diabetes mellitus(GDM).Methods A total of 256 pregnant women who received regular prenatal examination in the Fourth People’s Hospital of Langfang from March 2018 to March 2021 were selected and divided into GDM group(n=136)and non-GDM group(n=120)according to the results of oral glucose tolerance test(OGTT)in mid-pregnancy.General clinical data,serum levels of human kisspeptin,Omentin-1,Lipasin and adverse pregnancy outcomes in the first trimester were compared between the two groups.Results①Compared with the non-GDM group,the serum levels of human kisspeptin in early pregnancy(3.35±0.95 nmol/L vs 2.19±0.76 nmol/L)and Lipasin(3.29±0.43 ng/ml vs 1.07±0.06 ng/ml)in GDM group were higher(t=4.964,16.798,all P<0.01),and the serum level of Omentin-1(216.73±70.16 ng/ml vs 278.09±93.45 ng/ml)in early pregnancy was lower(t=3.326,P<0.05),the differences were statistically significant,respectively.②The serum level of human kisspeptin in early pregnancy were positively correlated with BMI before pregnancy,weight gain before 24 weeks of pregnancy,TG,FBG,1hPG,2hPG,FINS and HOMA-IR(r=0.286~0.564,all P<0.05),but negatively correlated with HOMA-β(r=-0.391,P<0.05).The serum level of Omentin-1 in early pregnancy was negatively correlated with BMI before pregnancy,weight gain before 24 weeks of pregnancy,FBG,1hPG,2hPG,FINS and HOMA-IR(r=-0.619~-0.206,all P<0.05),and positively correlated with HOMA-β(r=0.505,P<0.01).The serum level of Lipasin in early pregnancy was positively correlated with weight gain before 24 weeks of pregnancy,TG,FBG,1hPG,2hPG,FINS and HOMA-IR(r=0.363~0.611,all P<0.01),and negatively correlated with HOMA-β(r=-0.496,P<0.01).③Weight gain before 24 weeks of pregnancy,HOMA-IR,human kisspeptin,Omentin-1 and Lipasin were the independent influencing factors for the occurrence of GDM.④The AUC of human kisspeptin,omentin-1 and Lipasin

关 键 词：人吻素 网膜素-1 Lipasin 妊娠期糖尿病 

分 类 号：R714.256[医药卫生—妇产科学] R392.11[医药卫生—临床医学]