妊娠期糖尿病患者孕晚期血清CXCL12、GAS6水平与胎儿生长受限的关系  

Relationships between peripheral blood CXCL12 and GAS6 levels and fetal growth restriction in patients with gestational diabetes mellitus in late pregnancy

作　　者：凌剑梅 单委 王娟 马勤宜[1] LING Jianmei;SHAN Wei;WANG Juan;MA Qinyi(Department of Obstetrics,Nantong Maternal and Child Health Hospital,Nantong 226001,China)

机构地区：[1]南通市妇幼保健院产科,江苏南通226001

出　　处：《山东医药》2023年第31期24-27,共4页Shandong Medical Journal

基　　金：江苏省医学科研项目(S2020079)。

摘　　要：目的探讨妊娠期糖尿病(GDM)患者孕晚期血清C-X-C基序趋化因子配体12(CXCL12)、生长停滞特异性蛋白6(GAS6)水平与胎儿生长受限(FGR)的关系。方法选取143例孕晚期GDM孕妇为GDM组,同期另选取46名健康孕晚期孕妇为对照组。采用酶联免疫吸附法检测血清CXCL12、GAS6;收集GDM患者病历资料;根据是否发生FGR将GDM孕妇分为FGR组42例和非FGR组101例。用多因素Logistic回归分析孕晚期GDM孕妇发生FGR的影响因素;用受试者工作特征(ROC)曲线分析血清CXCL12、GAS6水平对孕晚期GDM孕妇发生FGR的预测价值。结果与对照组比较,GDM组血清CXCL12水平低,GAS6水平高(P均<0.05)。多因素Logistic回归分析显示,稳态模型评估-胰岛素抵抗、GAS6升高为孕晚期GDM孕妇发生FGR的独立危险因素,CXCL12升高为独立保护因素(P均<0.05)。ROC曲线分析显示,血清CXCL12、GAS6、CXCL12联合GAS6预测孕晚期GDM孕妇发生FGR的曲线下面积分别为0.783、0.784、0.869,二者联合预测的曲线下面积高于二者单独预测(P均<0.05)。结论GDM孕妇孕晚期血清CXCL12水平降低和GAS6水平升高与FGR密切相关,二者联合预测孕晚期GDM孕妇发生FGR的价值较高。Objective To investigate the relationships between peripheral blood levels of C-X-C motif chemokine ligand 12(CXCL12),growth arrest-specific protein 6(GAS6)and fetal growth restriction(FGR)in patients with gestational diabetes mellitus(GDM)in late pregnancy.Methods Totally 143 pregnant women with GDM in late pregnancy were selected as the GDM group,and another 46 healthy pregnant women in late pregnancy were selected as the control group during the same period.Enzyme-linked immunosorbent assay was used to detect the levels of CXCL12 and GAS6 in peripheral blood.The medical records of GDM patients were collected.The pregnant women with GDM were classified into the FGR group of 42 cases and the non-FGR group of 101 cases according to whether FGR occurred or not.Multifactorial Logistic regression was used to analyze the factors influencing the occurrence of FGR in pregnant women with GDM in late pregnancy.The predictive value of peripheral blood CXCL12 and GAS6 levels on the occurrence of FGR in pregnant women with GDM in late pregnancy was analyzed by using the receiver operating characteristic(ROC)curve.Results Compared with the control group,peripheral blood CXCL12 level decreased and GAS6 level increased in the GDM group(both P<0.05).The incidence of FGR in 143 pregnant women with GDM in late pregnancy was 29.37%(42/143).Multifactorial Logistic regression analysis showed that homeostatic model assessment-insulin resistance and elevated GAS6 were independent risk factors and CXCL12 was an independent protective factor for the development of FGR in pregnant women with GDM in late pregnancy(all P<0.05).ROC curve analysis showed that the area under the curve of peripheral blood CXCL12,GAS6,and CXCL12 combined with GAS6 in predicting the occurrence of FGR in pregnant women with GDM in late pregnancy were 0.783,0.784,and 0.869,respectively(all P<0.05).Conclusion Decreased peripheral blood CXCL12 level and increased GAS6 level in pregnant women with GDM in late pregnancy are closely related to FGR,and peripheral blood

关 键 词：妊娠期糖尿病 胎儿生长受限 C-X-C基序趋化因子配体12 生长停滞特异性蛋白6 

分 类 号：R714.25[医药卫生—妇产科学]