妊娠期糖尿病妇女血浆IL-1Ra水平及其与产后2型糖尿病的相关性研究  

The plasma level of IL-1Ra in women with gestational diabetes mellitus and its association with postpartum type 2 diabetes mellitus

作　　者：汤琳琳[1] 王雅萍[1] TANG Linlin;WANG Yaping(Department of Cynecology and Obstetrics,Nanjing First Hospital/Nanjing Hospital Afiliated to Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院妇产科,江苏南京210006

出　　处：《现代医学》2022年第7期864-870,共7页Modern Medical Journal

摘　　要：目的:探究妊娠期糖尿病(gestational diabetes mellitus, GDM)妇女血浆白介素-1受体拮抗剂(IL-1Ra)水平及其与产后2型糖尿病(type 2 diabetes mellitus, T2DM)的相关性。方法:选择2018年6月至2020年12月本院收治的120例GDM患者为研究组,同期选取120例来本院进行体检的妊娠期健康妇女为对照组,探究IL-1Ra在两组血浆中的水平以及其与GDM之间的相关性。对120例GDM患者进行12周的跟踪随访,根据是否发生T2DM再分为A、B两组(A组产后T2DM 52例,B组产后正常68例),通过对比两组患者相关指标,以探究IL-1Ra与产后T2DM发生的相关性。结果:研究组患者C肽、空腹血糖(fasting plasma glucose, FBG)、空腹胰岛素(fasting insulin, FINS)、糖化血红蛋白(glycosylated hemoglobin, HbA1c)水平及胰岛素抵抗指数(insulin resistance index, HOMA-IR)均显著高于对照组,而IL-1Ra水平显著低于对照组,差异均具有统计学意义(P<0.05)。研究组T2DM的发生率在43.33%,A组患者C肽、HbA1c、FBG、FINS水平及HOMA-IR均显著高于B组,而IL-1Ra水平显著低于B组,差异均具有统计学意义(P<0.05)。Spearman相关性分析显示,IL-1Ra水平与产前产后C肽、HbA1c、FBG、FINS水平以及HOMA-IR均呈负相关(均r<0,P<0.05)。Logistic回归分析显示,IL-1Ra、C肽、HbA1c、孕前BMI为GDM产后发生T2DM的影响因素(P<0.05)。ROC曲线分析结果表示,IL-1Ra对GDM的截断点为820 pg·ml,灵敏度为37.92%,特异度为79.53%;IL-1Ra对GDM产后发生T2DM的截断点为889 pg·ml,灵敏度为52.26%,特异度为67.15%。结论:IL-1Ra在GDM患者以及GDM产后T2DM患者血浆中的水平明显降低,IL-1Ra可能参与GDM和GDM产后T2DM的发生和发展。Objective: To investigate the plasma level of interleukin-1 receptor antagonist(IL-1 Ra) in women with gestational diabetes mellitus(GDM) and its correlation with postpartum type 2 diabetes mellitus(T2 DM). Methods: From June 2018 to December 2020, we selected 120 cases of patients from our hospital with GDM into study group. And at the same time, we also chose 120 healthy pregnancy women undergoing physical examinations into control group. We had followed up the 120 cases of GDM patients for 12 week and divided them into two groups according to the possible occurrence of T2 DM,52 cases of T2 DM in group A and 68 cases without T2 DM in group B. By comparing the related indicators of patients in these two groups, the correlation between IL-1 Ra and the occurrence of postpartum T2 DM was explored. Results: The levels of C-peptide, HbA1 c, FBG, FINS, HOMA-IR in the study group were significantly higher than those in the control group, while the levels of IL-1 Ra were significantly lower than those in the control group. The data differences were all of statistical significance(P<0.05). The incidence of T2 DM in the study group was 43.33%. The levels of C-peptide, HbA1 c, FBG, FINS and HOMA-IR in group A were significantly higher than those in group B, while the IL-1 Ra was significantly lower than that in group B. The data differences were all statistically significant(P<0.05). Spearman correlation analysis showed that IL-1 Ra had a significant negative correlation with C-peptide, HbA1 c, FBG, FINS and HOMA-IR before and after delivery(all r<0,P<0.05). Logistic regression analysis showed that IL-1 Ra, C-peptide, HbA1 c and BMI before pregnancy were the influencing factors of T2 DM after GDM(P<0.05). ROC curve analysis showed that the cut-off point of IL-1 Ra against GDM was 820 pg·ml, with a sensitivity of 37.92% and a specificity of 79.53%. The cut-off point of IL-1 Ra for T2 DM in postpartum GDM was 889 pg·ml, with a sensitivity of 52.26% and specificity of 67.15%. Conclusion: IL-1 Ra is significantly decreased i

关 键 词：白介素-1受体拮抗剂 妊娠期糖尿病 2型糖尿病 产后 

分 类 号：R714.7[医药卫生—妇产科学]