妊娠期糖尿病患者血清Endocan、ISM1水平及其与不良妊娠结局的关系  

The expression levels of serum Endocan and ISM1 in patients with gestational diabetes mellitus and their relationship with adverse pregnancy outcomes

作　　者：蒋惠玲[1] 许颖[1] 司向华 赵旭兴[1] 薛筱蕾 Jiang Huiling;Xu Ying;Si Xianghua;Zhao Xuxing;Xue Xiaolei(Department of Obstetrics,the Fifth Affiliated Hospital of Xinjiang Medical University,Xinjiang,Urumqi 830011,China)

机构地区：[1]新疆医科大学第五附属医院产科,乌鲁木齐830011

出　　处：《疑难病杂志》2024年第12期1484-1488,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D03C721)。

摘　　要：目的研究妊娠期糖尿病(GDM)患者血清内皮细胞特异性分子(Endocan)、Isthmin 1(ISM1)水平及其与不良妊娠结局的关系。方法选取2020年1月—2023年1月新疆医科大学第五附属医院产科诊治的GDM患者94例为GDM组,根据妊娠结局分为预后不良亚组36例和预后良好亚组58例,以同期体检的健康妊娠女性48例为健康对照组。采用酶联免疫吸附法检测血清Endocan、ISM1水平;采用Pearson相关分析血清Endocan、ISM1与血糖指标的相关性;Logistic回归模型和受试者工作特征曲线分析血清Endocan、ISM1对GDM患者不良妊娠结局的评估价值。结果GDM组血清Endocan、空腹血糖(FPG)、糖化血红蛋白(HbA 1c)、空腹胰岛素(FINS)及稳态模型胰岛素抵抗指数(HOMA-IR)高于健康对照组,血清ISM1低于健康对照组(t/P=21.588/<0.001,12.762/<0.001,13.945/<0.001,12.337/<0.001,14.308/<0.001,20.599/<0.001);GDM组患者FPG、HbA 1c、FINS及HOMA-IR与血清Endocan呈正相关,与血清ISM1呈负相关(Endocan:r/P=0.632/<0.001,0.701/<0.001,0.698/<0.001,0.727/<0.001;ISM1:r/P=-0.709/<0.001,-0.607/<0.001,-0.626/<0.001,-0.745/<0.001);与预后良好亚组比较,预后不良亚组GDM患者血清Endocan、HOMA-IR较高,血清ISM1较低(t/P=8.025/<0.001,7.988/<0.001,13.643/<0.001);血清Endocan高、HOMA-IR高是GDM患者不良妊娠结局的危险因素[OR(95%CI)=1.556(1.230~1.968),1.354(1.102~1.663)],ISM1高是保护因素[OR(95%CI)=0.681(0.543~0.855)];Endocan、ISM1及二者联合预测GDM患者不良妊娠结局的AUC分别为0.808、0.821、0.890,二者联合优于各自单独预测效能(Z=4.515、4.226,P均<0.001)。结论GDM孕妇血清Endocan水平升高,ISM1水平降低,均与机体糖代谢指标有关,两者联合对GDM患者妊娠结局预后具有较高的评估价值。Objective To study the expression of serum endothelial cell specific molecule(Endocan)and Isthmin1(ISM1)in patients with gestational diabetes mellitus(GDM)and their relationship with adverse pregnancy outcomes.Methods A total of 94 patients with GDM diagnosed and treated in the Department of Obstetrics,the Fifth Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2023 were selected as GDM group.According to the pregnancy outcome,they were divided into poor prognosis subgroup(36 cases)and good prognosis subgroup(58 cases),48 healthy pregnant women who underwent physical examinations during the same period were selected as the healthy control group.The levels of serum Endocan and ISM1 were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum Endocan,ISM1 and clinical indicators.Logistic regression model and receiver operating characteristic curve were used to analyze the evaluation value of serum Endocan and ISM1 on adverse pregnancy outcomes in GDM patients.Results Compared with the healthy control group,the serum Endocan,fasting blood glucose(FPG),glycosylated hemoglobin(HbA 1c),fasting insulin(FINS)and homeostasis model insulin resistance index(HOMA-IR)in the GDM group increased,and the serum ISM1 decreased(t/P=21.588/<0.001,12.762/<0.001,13.945/<0.001,12.337/<0.001,14.308/<0.001,20.599/<0.001);FPG,HbA lc,FINS and HOMA-IR were positively correlated with serum Endocan and negatively correlated with serum ISM1 in GDM group(r/P=0.632/<0.001,0.701/<0.001,0.698/<0.001,0.727/<0.001;-0.709/<0.001,-0.607/<0.001,-0.626/<0.001,-0.745/<0.001);Compared with the good prognosis subgroup,the poor prognosis subgroup had higher serum Endocan,HOMA-IR and lower serum ISM1(t/P=8.025/<0.001,7.988/<0.001,13.643/<0.001);High serum Endocan and HOMA-IR were risk factors for adverse pregnancy outcomes of GDM,and high ISM1 was a protective factor[OR(95%CI)=1.556(1.230-1.968),1.354(1.102-1.663),0.681(0.543-0.855)];The AUC of Endocan,ISM1 and

关 键 词：妊娠期糖尿病 内皮细胞特异性分子 Isthmin 1 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]