孕早期血清半乳糖凝集素3、微RNA-29a对孕妇发生妊娠糖尿病风险的预测价值分析  

Analysis of the predictive value of serum Gal-3 and miR-29a in early pregnancy for the risk of gestational diabetes mellitus in pregnant women

作　　者：倪南鹰 裴永红 张永 李海波[2] NI Nanying;PEI Yonghong;ZHANG Yong;LI Haibo(Department of Obstetrics and Gynecology,General Hospital of Eastern Command,Nanjing,Jiangsu 210002,China;Clinical Laboratory,Nantong Maternal and Child Health Care Hospital,Nantong,Jiangsu 226006,China)

机构地区：[1]东部战区总医院妇产科,江苏南京210002 [2]南通市妇幼保健院检验科,江苏南通226006

出　　处：《安徽医药》2024年第6期1135-1138,I0003,共5页Anhui Medical and Pharmaceutical Journal

基　　金：江苏省高层次卫生人才“六个一工程”拔尖人才科研项目(LGY2017040)。

摘　　要：目的分析孕早期血清半乳糖凝集素3(Gal-3)、微RNA(miR)-29a对孕妇发生妊娠糖尿病(GDM)风险的预测价值。方法选取2021年3月至2022年3月在东部战区总医院进行围生期检查的60例GDM病人作为GDM组,同期体检健康的孕妇60例作为对照组。抽取病人空腹静脉血,检测并比较两组间病人孕早期血清Gal-3(以酶联免疫吸附测定检测)、miR-29a(PCR法)表达水平。绘制受试者操作特征曲线(ROC曲线)评估孕早期血清Gal-3、miR-29a水平预测孕妇发生GDM风险的价值,行多因素logistic回归分析影响孕妇发生GDM的因素。结果GDM组血清低密度脂蛋白胆固醇(LDL-C)、Gal-3[(40.31±4.12)μg/L比(35.79±3.58)μg/L]、糖化血红蛋白(HbA1c)、服糖后2 h血糖(2 hPG)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)水平均明显高于对照组(P<0.05),空腹胰岛素(FINS)、miR-29a(26.78±2.72比30.46±3.09)水平明显低于对照组(P<0.05);绘制ROC曲线评估血清Gal-3、miR-29a水平预测GDM发生的价值显示,单独检测时,Gal-3的特异度86.67%最高,miR-29a的灵敏度90.00%最高,两者联合检测灵敏度、特异度均处于较高水平(95.00%、88.33%)。行多因素logistic回归分析显示,血清Gal-3、miR-29a、HOMA-IR、HbA1c为GDM发生的影响因素(P<0.05)。结论GDM病人孕早期血清Gal-3水平较高、miR-29a水平较低,可能为预测GDM发生的潜在指标,两者联合检测价值更高。Objective To analyze the predictive value of serum galectin 3(Gal-3)and microRNA(miR)-29a in early pregnancy for the risk of gestational diabetes mellitus(GDM)in pregnant women.Methods Sixty patients with GDM who underwent perinatal examination at the General Hospital of Eastern Command from March 2021 to March 2022 were enrolled in the GDM group,and 60 pregnant women who were physically healthy during the same period were enrolled in the control group.Fasting venous blood was drawn from the patients,and serum Gal-3(detected by enzyme-linked immunosorbent assay)and miR-29a(PCR method)expression levels in early pregnancy were detected and compared between the two groups.Receiver operating characteristic(ROC)curves were plotted to evaluate the value of serum Gal-3 and miR-29a levels in early pregnancy in predicting the risk of GDM in pregnant women,and multivariate logistic regression was performed to analyze the factors affecting the occurrence of GDM in pregnant women.Results The serum levels of low-density lipoprotein cholesterol(LDL-C),Gal-3[(40.31±4.12)μg/L vs.(35.79±3.58)μg/L],glycated hemoglobin A1c(HbA1c),2-h postglycemic(2 hPG),fasting plasma glucose(FPG),and the index of insulin resistance index(HOMA-IR)in the GDM group were significantly greater than those in the control group(P<0.05),and the levels of fasting insulin(FINS)and miR-29a(26.78±2.72 vs.30.46±3.09)were significantly lower in the GDM group than in the control group(P<0.05).ROC curve analysis of the ability of serum Gal-3 and miR-29a levels to predict the occurrence of GDM revealed that Gal-3 had the highest specificity of(86.67%)and that miR-29a had the highest sensitivity(90.00%)when detected alone,and the sensitivity and specificity of these two parameters were at a high level in the combined assay(95.00%and 88.33%,respectively).Multivariate logistic regression analysis revealed that serum Gal-3,miR-29a,HOMA-IR,and HbA1c were the influencing factors for the occurrence of GDM(P<0.05).Conclusion Patients with GDM had high levels of serum

关 键 词：糖尿病 妊娠 微RNA-29a 半乳糖凝集素3 孕早期 联合检测 

分 类 号：R714.256[医药卫生—妇产科学]