妊娠期糖尿病患者血清Nrf2、HO-1水平与妊娠结局的关系  

Relationship between serum Nrf2,HO-1 levels and pregnancy outcome in patients with gestational diabetes

作　　者：石海珩 龚丽娜[1] 张艳梅[1] 黄莺[1] 刘梦 Shi Haiheng;Gong Lina;Zhang Yanmei;Huang Ying;Liu Meng(Department of Obstetrics,Xinjiang Uygur Autonomous Region People’s Hospital,Xinjiang Province,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院产科,乌鲁木齐830000

出　　处：《疑难病杂志》2023年第8期862-867,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D01C101)。

摘　　要：目的分析妊娠期糖尿病(GDM)患者血清核因子E2相关因子2(Nrf2)、血红素氧合酶-1(HO-1)水平与妊娠结局的关系。方法选取2021年1月-2022年5月新疆维吾尔自治区人民医院产科收治的GDM患者132例为GDM组,根据妊娠结局分为结局不良亚组41例和结局良好亚组91例,另选取医院同期产检的健康孕妇64例为健康对照组。采用酶联免疫吸附法检测血清Nrf2、HO-1水平。Pearson相关性分析GDM患者血清Nrf2与HO-1水平的关系,多因素Logistic回归分析GDM患者妊娠结局不良的影响因素,受试者工作特征曲线(ROC)分析血清Nrf2、HO-1预测GDM患者妊娠结局不良的价值。结果与健康对照组比较,GDM组血清Nrf2、HO-1水平升高(t/P=10.834/<0.001、14.359/<0.001)。GDM患者血清Nrf2与HO-1水平呈正相关(r/P=0.721/<0.001)。132例GDM患者妊娠结局不良发生率为31.06%(41/132),结局不良亚组血清HbA_(1c)、HOMA-IR、Nrf2、HO-1水平高于结局良好亚组[t(Z)/P=3.111/0.002、5.220/<0.001、5.555/<0.001、5.517/<0.001]。HbA_(1c)、HOMA-IR、Nrf2、HO-1升高为GDM患者妊娠结局不良的独立危险因素[OR(95%CI)=2.599(1.330~5.079)、2.383(1.481~3.833)、1.085(1.041~1.130)、1.077(1.037~1.120)];血清Nrf2、HO-1水平单独与二者联合预测GDM患者妊娠结局不良的AUC分别为0.770、0.769、0.886,二者联合预测的AUC高于各自单独预测(Z/P=2.861/0.004、2.936/0.003)。结论血清Nrf2、HO-1水平与GDM患者妊娠结局不良独立相关,二者联合预测GDM患者妊娠结局不良的价值较高,可能成为GDM患者妊娠结局不良的辅助预测指标。Objective To analyze the relationship between serum levels of nuclear factor E2 related factor 2(Nrf2),heme oxygenase-1(HO-1)and pregnancy outcome in patients with gestational diabetes(GDM).Methods One hundred and thirty-two GDM patients admitted to the obstetrics department of Xinjiang Uygur Autonomous Region People's Hospital from January 2021 to May 2022 were selected as the GDM group.According to pregnancy outcomes,they were divided into 41 poor outcome subgroups and 91 good outcome subgroups.Additionally,64 healthy pregnant women who underwent prenatal examinations at the same time were selected as the healthy control group.Enzyme-linked immunosorbent assay was used to detect serum Nrf2 and HO-1 levels.Pearson correlation analysis of the relationship between serum Nrf2 and HO-1 levels in GDM patients,multivariate logistic regression analysis of the influencing factors of poor pregnancy outcomes in GDM patients,and subject work characteristic curve(ROC)analysis of the value of serum Nrf2 and HO-1 in predicting poor pregnancy outcomes in GDM patients.Results Compared with the healthy control group,the serum Nrf2 and HO-1 levels in the GDM group increased(t/P=10.834/<0.001,14.359/<0.001).There is a positive correlation between serum Nrf2 and HO-1 levels in GDM patients(r/P=0.721/<0.001).The incidence of adverse pregnancy outcomes in 132 GDM patients was 31.06%(41/132),and the serum HbA1c,HOMA-IR,Nrf2,and HO-1 levels in the poor outcome subgroup were higher than those in the good outcome subgroup[t(Z)/P=3.111/0.002,5.220/<0.001,5.555/<0.001,5.517/<0.001].Elevated HbA_(1c),HOMA-IR,Nrf2,and HO-1 are independent risk factors for poor pregnancy outcomes in GDM patients[OR(95%CI)=2.599(1.330-5.079),2.383(1.481-3.833),1.085(1.041-1.130),and 1.077(1.037-1.120)].The AUC of poor pregnancy outcomes in GDM patients predicted by serum Nrf2 and HO-1 levels alone and in combination were 0.770,0.769,and 0.886,respectively.The AUC predicted by the combination of the two was higher than that predicted separately(Z/P=2.861/0.004,

关 键 词：妊娠期糖尿病 核因子E2相关因子2 血红素氧合酶-1 妊娠结局 预测 

分 类 号：R587.1[医药卫生—内分泌] R[医药卫生—内科学]