血清载脂蛋白C3、脂蛋白酯酶在妊娠期糖尿病中表达水平及临床意义  

Study on the expression levels and clinical significance of serum ApoC3 and LPL in gestational diabetes

作　　者：张英 梁登辉[2] 王德亮 ZHANG Ying;LIANG Denghui;WANG Deliang(Department of Obstetrics and Gynecology,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou,Hebei 075000,China;Department of Reproductive Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Obstetrics,Dezhou People's Hospital,Dezhou,Shandong 253000,China)

机构地区：[1]张家口市妇幼保健院妇产科,河北张家口075000 [2]河北北方学院附属第一医院生殖医学科,河北张家口075000 [3]德州市人民医院产科,山东德州253000

出　　处：《安徽医药》2024年第11期2240-2245,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨妊娠期糖尿病(GDM)病人血清载脂蛋白C3(ApoC3)、脂蛋白酯酶(LPL)水平变化及其临床意义。方法选取2020年1月至2021年1月张家口市妇幼保健院收治的GDM病人100例为GDM组,健康孕妇104例为对照组,另根据是否发生新生儿不良结局,将GDM病人分为结局不良组(27例)和结局良好组(73例)。收集两组血脂、血糖指标,采用酶联免疫吸附测定检测血清中ApoC3、LPL水平。采用Pearson法分析GDM病人血清ApoC3、LPL与血糖、血脂相关指标及HOMA-IR的相关性;多因素logistic回归分析影响GDM病人新生儿不良结局的因素;ROC曲线分析血清ApoC3、LPL水平对GDM病人新生儿不良结局的预测价值。结果GDM组血清LPL[(38.03±15.80)μg/L比(46.58±9.75)μg/L]、高密度脂蛋白胆固醇(HDL-C)[(1.16±0.31)mmol/L比(1.53±0.37)mmol/L]水平均低于对照组(P<0.05),ApoC3[(180.37±47.37)mg/L比(144.62±35.83)mg/L]、总胆固醇(TC)[(5.22±1.05)mmol/L比(4.35±0.96)mmol/L]、三酰甘油(TG)[(2.36±0.74)mmol/L比(1.39±0.58)mmol/L]、低密度脂蛋白胆固醇(LDL-C)[(3.18±0.97)mmol/L比(2.51±0.72)mmol/L]、空腹血糖(FPG)[(6.27±1.60)mmol/L比(4.64±1.53)mmol/L]、空腹胰岛素(FINS)[(1.84±0.69)mU/L比(1.42±0.54)mU/L]及胰岛素抵抗指数(HOMA-IR)(6.12±1.48比4.23±1.28)均高于对照组(P<0.05)。GDM病人血清ApoC3与TG、TC、LDL-C、FPG、FINS及HOMA-IR呈正相关(P<0.05),与HDL-C呈负相关(P<0.05);GDM病人血清LPL与TG、TC、LDL-C、FPG、FINS及HOMA-IR呈负相关(P<0.05),与HDL-C呈正相关(P<0.05)。GDM病人血清ApoC3与LPL水平呈负相关(r=−0.39,P<0.05)。结局不良组病人FINS、HOMA-IR及血清ApoC3水平高于结局良好组,LPL水平均低于结局良好组(P<0.05)。HOMA-IR、ApoC3是影响GDM病人新生儿不良结局的独立危险因素,LPL是影响GDM病人新生儿不良结局的保护因素(P<0.05)。血清ApoC3、LPL水平联合预测GDM病人新生儿不良结局的曲线下面积为0.916,明显高于血清ApoC3、LPL水平单独预测Objective To investigate the changes of serum apolipoprotein C3(ApoC3)and lipoprotein lipase(LPL)levels in patients with gestational diabetes(GDM)and their clinical significance.Methods A total of 100 cases of GDM patients admitted to our hospital from January 2020 to January 2021 were selected as the GDM group,and 104 healthy pregnant women were selected as the control group.In addition,according to whether adverse neonatal outcomes occurred,GDM patients were divided into the poor outcome group(27 cases)and the good outcome group(73 cases).The blood lipids and blood glucose indicators of the two group were collected,the levels of ApoC3 and LPL in serum were detected with enzyme-linked immunoassay.Pearson method was used to analyze the correlation between serum ApoC3,LPL,blood glucose,blood lipid and HOMA-IR in patients with GDM;Multivariate logistic regression was used to analyze the influencing factors of adverse neonatal outcomes in GDM patients;ROC curve analysis of serum ApoC3 and LPL levels to predict the adverse outcome of newborns in GDM patients.Results The levels of serum LPL[(38.03±15.80)μg/L vs.(46.58±9.75)μg/L]and high-density lipoprotein cholesterol(HDL-C)[(1.16±0.31)mmol/L vs.(1.53±0.37)mmol/L]in the GDM group were lower than those in the control group(P<0.05).ApoC3[(180.37±47.37)mg/L vs.(144.62±35.83)mg/L],total cholesterol(TC)[(5.22±1.05)mmol/L vs.(4.35±0.96)mmol/L],triglycerides(TG)[(2.36±0.74)mmol/L vs.(1.39±0.58)mmol/L],low-density lipoprotein cholesterol(LDL-C)levels[(3.18±0.97)mmol/L vs.(2.51±0.72)mmol/L],fasting blood glucose(FPG)[(6.27±1.60)mmol/L vs.(4.64±1.53)mmol/L],fasting insulin(FINS)[(1.84±0.69)mU/L vs.(1.42±0.54)mU/L]and insulin resistance index(HOMA-IR)(6.12±1.48 vs.4.23±1.28)were all higher than those in the control group(P<0.05).Serum ApoC3 in patients with GDM was positively correlated with TG,TC,LDL-C,FPG,FINS and HOMA-IR(P<0.05),and negatively correlated with HDL-C(P<0.05);serum LPL in GDM patients was negatively correlated with TG,TC,LDL-C,FPG,FINS and HO

关 键 词：糖尿病 妊娠 载脂蛋白C3 脂蛋白酯酶 临床意义 

分 类 号：R714.256[医药卫生—妇产科学]