妊娠期糖尿病患者血清INHA、GCD59水平变化及其对不良妊娠结局的预测效能  

Changes of serum INHA and GCD59 levels in patients with gestational diabetes and their predictive efficacy for adverse pregnancy outcomes

作　　者：鹿莎 李瑞华 沈冉 王芳 赵颖 LU Sha;LI Ruihua;SHEN Ran;WANG Fang;ZHAO Ying(Obstetrics and Gynecology,Kunming Yan'an Hospital,Kunming 650000,China)

机构地区：[1]昆明市延安医院产科,昆明650000

出　　处：《山东医药》2023年第36期10-14,共5页Shandong Medical Journal

基　　金：云南省卫生健康委科研课题(2020J019)。

摘　　要：目的观察妊娠期糖尿病(GDM)患者血清抑制素A(INHA)、糖化分化簇59(GCD59)水平变化,并分析其对不良妊娠结局的预测效能。方法GDM孕妇97例(观察组)、同期健康孕妇100例(对照组),采用酶联免疫吸附法检测两组血清INHA、GCD59;根据是否发生不良妊娠结局将观察组分为不良组(31例)和良好组(66例),采用单因素和多因素Logistic回归分析法分析GDM患者不良妊娠结局的影响因素;绘制ROC,分析血清INHA、GCD59水平对GDM患者不良妊娠结局的预测效能。结果与对照组比较,观察组血清INHA、GCD59水平升高(P均<0.05)。不良组和良好组INHA、GCD59、HbA1C、HOMA-IR比较,P均<0.05;INHA、GCD59、HOMA-IR升高为GDM患者不良妊娠结局的独立危险因素(P均<0.05)。血清INHA水平预测GDM患者不良妊娠结局的最佳截断值为1209.95 pg/mL,曲线下面积(AUC)为0.788(0.693~0.864),灵敏度、特异度、Youden指数分别为90.32%、59.09%、0.494;血清GCD59水平预测GDM患者不良妊娠结局的最佳截断值为3.60 ng/mL,AUC为0.785(0.690~0.862),灵敏度、特异度、Youden指数分别为90.30%、51.52%、0.418;血清INHA、GCD59水平联合预测GDM患者不良妊娠结局的AUC为0.897(0.819~0.949),灵敏度、特异度、Youden指数分别为83.97%、89.39%、0.733。结论GDM患者血清INHA、GCD59水平升高,是GDM患者不良妊娠结局的危险因素,检测两指标有助于GDM患者不良妊娠结局的预测。Objective To observe the changes of serum inhibin A(INHA)and glycated cluster of differentiation 59(GCD59)levels in patients with gestational diabetes mellitus(GDM),and to analyze their predictive efficacy for adverse pregnancy outcomes.Methods Ninety-seven pregnant women with GDM(observation group)and 100 healthy pregnant women in the same period(control group)were selected.The serum INHA and GCD59 levels in both groups were detected by enzyme-linked immunosorbent assay.According to the occurrence of adverse pregnancy outcome,the observation group was divided into adverse group(31 cases)and good group(66 cases).Univariate and multivariate Logistic regression analyses were used to analyze the influencing factors of adverse pregnancy outcome in pregnant women with GDM.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of serum INHA and GCD59 levels for adverse pregnancy outcomes in GDM patients.Results Compared with the control group,serum INHA and GCD59 levels increased in the observation group(both P<0.05).Significant differences were found in the INHA,GCD59,HbA1c,and HOMA-IR between the adverse group and the good group(all P<0.05).Elevated INHA,GCD59,and HOMA-IR were independent risk factors for adverse pregnancy outcomes in patients with GDM(all P<0.05).The best cut-off value of serum INHA level in predicting adverse pregnancy outcome in GDM patients was 1209.95 pg/mL,and the area under the curve(AUC)was 0.788(0.693-0.864),the sensitivity,specificity,and Youden index were 90.32%,59.09%,and 0.494,respectively.The best cut-off value of serum GCD59 level in predicting adverse pregnancy outcomes in GDM patients was 3.60 ng/mL,AUC was 0.785(0.690-0.862),sensitivity,specificity,and Youden index were 90.30%,51.52%,and 0.418,respectively.The AUC of serum INHA and GCD59 levels in predicting the adverse pregnancy outcomes in GDM patients was 0.897(0.819 to 0.949),and the sensitivity,specificity,and Youden index were 83.97%,89.39%,and 0.733,respectively.Conclusion Elevated serum INHA

关 键 词：抑制素A 糖化分化簇59 妊娠期糖尿病 妊娠结局 

分 类 号：R587.1[医药卫生—内分泌] R714.256[医药卫生—内科学]