孕早期母体血清腐胺水平预测妊娠期糖尿病的临床价值  

Clinical value of maternal serum putrescine levels in the early pregnancy in predicting gestational diabetes mellitus

作　　者：李虹[1] 王雯智[2] 折开娥[1] 吴桂清[1] 沈鑫[1] Li Hong;Wang Wenzhi;She Kai’e;Wu Guiqing;Shen Xin(Department of Obstetrics,Shaanxi Provincial People’s Hospital,Xi’an 710001,China;Department of Gynaecology,Shaanxi Provincial People’s Hospital,Xi’an 710001,China)

机构地区：[1]陕西省人民医院产科,西安710001 [2]陕西省人民医院妇科,西安710001

出　　处：《广西医科大学学报》2022年第12期1993-2000,共8页Journal of Guangxi Medical University

基　　金：陕西省重点研发计划项目资助(No.2020SF-050)。

摘　　要：目的:基于代谢组学筛选妊娠期糖尿病(GDM)生物标志物,并探讨孕早期血清腐胺水平对GDM的预测价值。方法:选择2020年3月至2021年4月本院50例GDM孕妇(GDM组)和100例年龄和体重指数相匹配的正常血糖孕妇作为对照组,收集孕8~12周血清样本。每组随机选择10份样本,采用液相色谱—串联质谱(LC-MS/MS)进行代谢组学分析;并进一步采用LCMS/MS法检测所有血清样本腐胺水平;使用受试者工作特性(ROC)曲线和曲线下面积(AUC)来评估预测模型的效能。结果:经代谢组学分析,血清中鉴定出7种主要的差异代谢产物,仅血清腐胺水平在GDM组和对照组有显著差异(P<0.05);与对照组相比,GDM组孕早期血清腐胺水平升高;孕早期血清腐胺水平预测GDM的AUC为0.819,对于GDM有良好的预测效能;经单因素和多因素Logistic回归分析,孕早期血清腐胺水平>96.61μmol/L是GDM的危险因素。结论:孕早期血清腐胺水平升高与妊娠后期较高的GDM风险相关,有望成为GDM可靠的预测生物标志物。Objective:To screen biomarkers of gestational diabetes mellitus(GDM)based on metabolomics and explore the predictive value of serum putrescine levels in the early pregnancy for GDM.Methods:From March 2020 to April 2021,50 pregnant women with GDM and 100 normoglycemic pregnant women matched for age and body mass index were included as the control group,and serum samples from 8 to 12 weeks of pregnancy were collected.Ten samples from each group were randomly selected for metabolomic analysis by liquid chromatography-tandem mass spectrometry(LC-MS/MS).All serum samples were further tested for putrescine levels by LC-MS/MS.Receiver operating characteristic(ROC)curves and area under the curve(AUC)were used to evaluate the value of predictive models.Results:Seven major differential metabolites were identified in serum by metabolomic analysis,but only serum putrescine levels were different between GDM group and control group(P<0.05).Compared with the control group,serum putrescine levels were generally higher in the GDM group in the early pregnancy.The ROC curve and AUC analysis showed that the serum putrescine levels(the AUC was 0.819)in the early pregnancy had good predictive power for GDM.Univariate and multivariate Logistic regression analysis showed that serum putrescine levels>96.61μmol/L in the early pregnancy was an independent risk factor for GDM.Conclusion:Elevated serum putrescine levels in the early pregnancy are associated with a higher risk of GDM in the late pregnancy and are expected to be a reliable predictive biomarker for GDM.

关 键 词：孕早期 妊娠期糖尿病 代谢组学 血清腐胺 

分 类 号：R587.1[医药卫生—内分泌]