孕早期血清CHI3L1、SOCS3水平预测妊娠期糖尿病价值  

Predictive value of the levels of serum chitinase 3-like protein 1 and suppressor of cytokine signaling 3 for gestational diabetes mellitus during the first trimester of pregnancy

作　　者：许红蕊 魏敬艳 刘瑶[1] 史少文 XU Hongrui;WEI Jingyan;LIU Yao;SHI Shaowen(The First Hospital of Qinhuangdao,Qinhuangdao,Hebei Province,066000)

机构地区：[1]河北省秦皇岛市第一医院,066000

出　　处：《中国计划生育学杂志》2022年第11期2615-2619,共5页Chinese Journal of Family Planning

基　　金：秦皇岛市科学技术研究与发展计划项目(202004A121)。

摘　　要：目的:探讨孕妇孕早期血清壳多糖酶3样蛋白1(CHI3L1)、细胞因子信号转导抑制因子3(SOCS3)水平对妊娠期糖尿病(GDM)的预测价值。方法:收集2019年6月-2021年6月本院妇产科行产前检查的孕妇340例作为研究对象,于妊娠24~28周口服75g葡萄糖耐量试验(OGTT),分为GDM组(n=100)和健康组(n=240),酶联免疫吸附法检测孕早期血清CHI3L1、SOCS3水平并进行组间比较。采用Pearson相关分析探讨孕早期血清CHI3L1、SOCS3与空腹血糖、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)的关系,采用受试者工作特征曲线(ROC)评估孕早期血清CHI3L1、SOCS3对GDM的预测价值,采用多因素logistic回归分析GDM发生的相关因素。结果:GDM组孕早期血清CHI3L1(115.62±20.11 pg/ml)、SOCS3(2.36±0.55 mg/ml)水平均高于健康组(22.25±6.24 pg/ml、0.63±0.12 mg/ml)(均P<0.05)。GDM孕妇孕早期血清CHI3L1、SOCS3水平与空腹血糖、FINS、HOMA-IR呈正相关(均P<0.05)。ROC曲线结果显示,孕早期血清CHI3L1预测GDM的曲线下面积为0.768,截断值78.4pg/ml,敏感度93.0%、特异度54.3%;SOCS3预测GDM的曲线下面积为0.831,截断值1.2mg/ml,敏感度93.0%、特异度67.1%,二指标联合预测GDM的曲线下面积为0.920,敏感度87.0%、特异度85.0%。多因素分析,孕早期血清CHI3L1[OR(95%CI)=4.10(1.92~8.78)]、SOCS3[OR(95%CI)=3.93(2.01~7.68)]均为影响GDM发生的危险因素(均P<0.05)。结论:GDM患者孕早期血清CHI3L1、SOCS3水平升高,二者均是GDM发生的独立影响因素,且对GDM发生有一定预测价值。Objective:To explore the predictive value of the levels of serum chitinase 3-like protein 1(CHI3L1)and suppressor of cytokine signaling 3(SOCS3)levels for gestational diabetes mellitus(GDM)of pregnant women during the first trimester of pregnancy.Methods:A total of 340 pregnant women who underwent pregnancy examinations were selected as the research subjects from June 2019 to June 2021.Based on the results of 75g glucose tolerance test(OGTT)administered orally for these women during 24-28 gestational weeks,the women were divided into group A(100 women with GDM)and group B(240 healthy pregnant women).The serum CHI3L1 and SOCS3 levels of the women in the two groups during the first trimester of pregnancy were detected by enzyme-linked immunosorbent assay,and which of the women were compared between the two groups.Pearson correlation analysis was used to investigate the relationship between the serum CHI3L1 and SOCS3 levels of the women during the first trimester of pregnancy and their levels of fasting blood glucose and fasting insulin(FINS),and their homeostasis model assessment of insulin resistance(HOMA-IR).Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the serum CHI3L1 and SOCS3 levels during the first trimester of pregnancy for GDM.Multivariate logistic regression analysis was used to analyze the related factors of GDM occurrence.Results:The levels of serum CHI3L1(115.62±20.11 pg/ml)and SOCS3(2.36±0.55 mg/ml)of the women in group A were significantly higher than those(22.25±6.24 pg/ml and 0.63±0.12 mg/ml)of the women in group B(all P<0.05).In group A,the serum CHI3L1 and SOCS3 levels of the women were positively correlated with the levels of their fasting blood glucose and FINS,and their HOMA-IR value(all P<0.05).ROC curve showed that the area under the curve,the cut-off value,the sensitivity,and the specificity of the serum CHI3L1 level of the women during the first trimester of pregnancy for predicting their GDM were 0.768,78.4pg/ml,93.0%,and 54.3%,respectively.T

关 键 词：妊娠期糖尿病 孕早期 壳多糖酶3样蛋白1 细胞因子信号转导抑制因子3 预测价值 

分 类 号：R714.256[医药卫生—妇产科学]