IKKε和FABP4与妊娠期糖尿病患者糖脂代谢水平和妊娠结局的关系  

Relationship of IKKεand FABP4 with glucose and lipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus

作　　者：闫璐 李维玲[1] 殷婷 张金辉 Yan Lu;Li Weiling;Yin Ting;Zhang Jinhui(Department of Gynecology and Obstetrics,Xi'an Gaoxin Hospital,Xi'an 710075,China)

机构地区：[1]西安高新医院妇产科,西安710075

出　　处：《国际医药卫生导报》2024年第21期3646-3650,共5页International Medicine and Health Guidance News

基　　金：陕西省自然科学基础研究计划(2020JQ-938)。

摘　　要：目的探究核因子-κB抑制物激酶ε(IKKε)、脂肪酸结合蛋白4(FABP4)与妊娠期糖尿病(GDM)患者糖脂代谢水平和妊娠结局的关系。方法回顾性选取2020年6月至2023年12月在西安高新医院进行产检确诊GDM的患者125例。年龄22~36(28.77±3.02)岁;确诊孕周为24~28(26.14±0.87)周。患者均进行血清IKKε、FABP4水平及糖脂代谢指标检测,根据患者妊娠结局将其分为妊娠良好组(92例)和妊娠不良组(33例)。Pearson法分析血清IKKε、FABP4与患者糖脂代谢的相关性,logistic回归分析患者妊娠结局的影响因素,采用受试者操作特征曲线(ROC)分析血清IKKε、FABP4水平对患者妊娠结局的预测价值。统计学方法采用t检验、χ^(2)检验。结果妊娠不良组IKKε、FABP4、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、甘油三酯(TG)、总胆固醇(TC)水平均高于妊娠良好组(均P<0.05)。Pearson法显示,血清IKKε、FABP4水平与FBG、HbAlc、TG、TC均呈正相关(r=0.543、0.621、0.354、0.312、0.705、0.658、0.433、0.365,均P<0.05)。多因素logistic回归分析显示,IKKε(OR=3.287,95%CI 1.994~5.418)、FABP4(OR=3.942,95%CI 1.754~8.856)、FBG(OR=2.857,95%CI 1.416~5.762)、TC(OR=4.133,95%CI 2.190~7.799)是患者不良妊娠结局的独立危险因素(均P<0.05)。ROC显示,血清IKKε、FABP4、二者联合预测患者妊娠结局的敏感度分别为72.70%、75.80%、90.90%,特异度分别为73.90%、71.70%、91.30%,AUC分别为0.802、0.829、0.923(均P<0.05)。结论GDM患者血清IKKε、FABP4与糖脂代谢指标FBG、HbAlc、TG、TC水平均呈正相关,且血清IKKε、FABP4是影响患者不良妊娠的独立危险因素,通过联合测定IKKε与FABP4水平可有效预测患者妊娠结局。Objective To explore the relationship of nuclear factors-κB inhibitor kinaseε(IKKε)and fatty acid binding protein 4(FABP4)with glucose and lipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods One hundred and twenty-five patients with GDM confirmed by prenatal examinations at Xi'an Gaoxin Hospital from June 2020 to December 2023 were selected.They were 22-36(28.77±3.02)years old and 24-28(26.14±0.87)weeks pregnant.The serum levels IKKεand FABP4 and glucose and lipid metabolism indicators in all the patients were detected.According to the pregnancy outcomes,the patients were divided into a good pregnancy group(92 cases)and a poor pregnancy group(33 cases).The correlations of serum IKKεand FABP4 with glucose and lipid metabolism in the patients were analyzed using the Pearson's method.The factors influencing the pregnancy outcomes in the patients were analyzed using the logistic regression.The predictive values of serum IKKεand FABP4 on pregnancy outcomes in the patients were analyzed using the receiver operating characteristic curves(ROC).t andχ^(2)tests were applied.Results The levels of IKKε,FABP4,fasting blood glucose(FBG),glycosylated hemoglobin type A1C(HbAlc),triglycerides(TG),and total cholesterol(TC)in the good pregnancy group were higher than those in the good pregnancy group(all P<0.05).The Pearson's analysis showed that the serum levels of IKKεand FABP4 were positively correlated with FBG,HbAlc,TG,and TC(r=0.543,0.621,0.354,0.312,0.705,0.658,0.433,and 0.365;all P<0.05).The multivariate logistic regression analysis showed that IKKε(OR=3.287,95%CI 1.994-5.418),FABP4(OR=3.942,95%CI 1.754-8.856),FBG(OR=2.857,95%CI 1.416-5.762),and TC(OR=4.133,95%CI 2.190-7.799)were independent risk factors for adverse pregnancy outcomes in the patients(all P<0.05).The ROC displayed that the sensitivities of serum IKKε,FABP4,and their combination in predicting pregnancy outcomes in the patients was 72.70%,75.80%,and 90.90%;the specificities were 73.90%,71.70%,and 91.

关 键 词：妊娠期糖尿病 糖脂代谢 核因子‐κB抑制物激酶ε 脂肪酸结合蛋白4 妊娠结局 影响因素 

分 类 号：R714.256[医药卫生—妇产科学]