PGC-1α、miR-222-3p在妊娠糖尿病易感性中的交互作用及预测价值研究  

The interaction and predictive value of PGC-1αand miR-222-3p in susceptibility to gestational diabetes mellitus

作　　者：高镜云 郭艺 肖宴 曾灵 华诏召 GAO Jingyun;GUO Yi;XIAO Yan;ZENG Ling;HUA Zhaozhao(Department of Obstetrics,the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang,Guizhou 550001,China)

机构地区：[1]贵州中医药大学第二附属医院产科,贵州贵阳550001

出　　处：《徐州医科大学学报》2023年第8期557-564,共8页Journal of Xuzhou Medical University

基　　金：贵州省卫生健康委科学技术基金(gzwkj2023-057)。

摘　　要：目的探讨过氧化物酶体增殖物激活受体-γ辅激活因子-1α(PGC-1α)、微小RNA-222-3p(miR-222-3p)在妊娠糖尿病(GDM)易感性中的交互作用及预测价值。方法选取2021年1月—2022年5月在贵州中医药大学第二附属医院建档的GDM高危孕妇136例作为研究对象。孕12~13周检测血清PGC-1α、miR-222-3p水平,孕24周~28周时进行75 g葡萄糖糖耐量试验(OGTT),并检测空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、血脂4项等指标,计算胰岛素抵抗指数(HOMA-IR)。根据OGTT结果分为正常组、GDM组,对比2组临床资料、糖脂代谢指标、血清PGC-1α、miR-222-3p水平,Pearson相关系数分析血清PGC-1α、miR-222-3p水平与糖脂代谢指标相关性。分析PGC-1α、miR-222-3p与GDM发生的独立关系及在GDM易感性中的交互作用,绘制受试者工作特征曲线(ROC曲线)评估血清PGC-1α、miR-222-3p水平对GDM的预测价值。结果GDM组年龄、孕前体质量指数、GDM史、孕前有多囊卵巢综合征比例、空腹血糖(FPG)、餐后1 h血糖(1h PG)、餐后2 h血糖界值(2h PG)、FINS、HOMA-IR、HbA1c、甘油三酯(TG)、总胆固醇(TC)、miR-222-3p高于正常组,PGC-1α低于对照组(P<0.05);血清PGC-1α水平与FPG、FINS、HOMA-IR呈负相关,miR-222-3p水平与FPG、FINS、HOMA-IR呈正相关(P<0.05);PGC-1α、miR-222-3p联合评估GDM的AUC值高于二者单独评估的AUC值(Z统计/P=3.504/0.001,2.467/0.014);调整混杂因素后,PGC-1α、miR-222-3p仍与GDM的发生独立相关(P<0.05);PGC-1α与miR-222-3p对GDM易感性存在拮抗作用,在PGC-1α与miR-222-3p共存的GDM易感性中,有41.0%是由两者交互作用引起的。结论PGC-1α、miR-222-3p在GDM易感性中存在拮抗作用,二者联合对提高GDM预测价值具有重要意义。Objective To investigate the interaction and predictive value of peroxisome proliferator-activated receptor-γ-coactivator 1α(PGC-1α)and micrornA-222-3p(miR-222-3p)in susceptibility to gestational diabetes mellitus(GDM).Methods A total of 136 pregnant women at high risk of GDM who were registered in the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2021 to May 2022 were selected as the subjects.The levels of serum PGC-1αand miR-222-3p were detected at 12 to 13 weeks'gestation.Then,75 g glucose glucose tolerance test(OGTT)was performed at 24 to 28 weeks'gestation.The fasting insulin(FINS),glycocated hemoglobin(HbA1c)and blood lipid were detected,while the insulin resistance index(HOMA-IR)was calculated.According to OGTT results,the pregnant women were divided into two groups:a normal group and a GDM group.The two groups were compared for clinical data,glycolipid metabolism indexes,serum PGC-1α and miR-222-3p levels.Pearson correlation coefficient was used to analyze the correlation between serum PGC-1α and miR-222-3p levels and glycolipid metabolism indexes.The independent relationship between PGC-1α,miR-222-3p and GDM and their interaction in susceptibility to GDM were analyzed.A receiver operating characteristic curve(ROC curve)was plotted to evaluate the predictive value of serum PGC-1α and miR-222-3p levels for GDM.Results Compared with the normal group,the GDM group showed increases in age,prepregnancy body mass index,history of GDM,prepregnancy proportion of polycystic ovary syndrome,fasting blood glucose(FPG),1 h postprandial blood glucose(1 h PG),2 h postprandial blood glucose threshold(2 h PG),FINS,HOMA-IR,HbA1c,triglyceride(TG),total cholesterol(TC)and miR-222-3p,as well as decreases in PGC-1α(P<0.05).Serum PGC-1α level was negatively correlated with FPG,FINS and HOMA-IR,while miR-222-3p level was positively correlated with FPG,FINS and HOMA-IR(P<0.05).The AUC value of GDM assessed by PGC-1α and miR-222-3p was higher than that assessed by them alo

关 键 词：过氧化物酶体增殖物激活受体-γ辅激活因子-1α miR-222-3p 糖化血红蛋白 受试者工作特征曲线 妊娠糖尿病 易感性 

分 类 号：R587.1[医药卫生—内分泌]