妊娠期糖尿病患者IAA、ICA、GADA联合检测对妊娠结局的预测价值  

Predictive value of combined IAA,ICA,and GADA tests for pregnancy outcome in patients with gestational diabetes mellitus

作　　者：牛洁 张金华 赵洪莲 任旖琳 佟爱华 Niu Jie;Zhang Jinhua;Zhao Honglian;Ren Yilin;Tong Aihua(Department of Endocrinology,Linyi Central Hospital,Linyi 276400,China;Department of Geriatrics,Linyi Central Hospital,Linyi 276400,China;Department of Obstetrics,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院内分泌科,临沂276400 [2]临沂市中心医院老年病科,临沂276400 [3]临沂市中心医院产科,临沂276400

出　　处：《中华内分泌外科杂志（中英文）》2024年第6期801-805,共5页Chinese Journal of Endocrine Surgery

基　　金：山东省临沂市重点研发计划(2022YXOO19)。

摘　　要：目的分析胰岛素自身抗体(IAA)、胰岛细胞抗体(ICA)、血清谷氨酸脱羧酶抗体(GADA)联合检测对妊娠期糖尿病(GDM)患者妊娠结局的预测价值。方法回顾性选取120例临沂市中心医院2020年10月至2023年10月收治的GDM患者为研究对象,依据随访至分娩时的妊娠结局,分为不良妊娠结局组和正常妊娠结局组,分别为37例和83例。统计研究对象妊娠不良结局发生情况,对GDM不良妊娠结局进行单因素和多因素分析。结果120例研究对象中有37例出现不良妊娠结局,其中巨大儿、剖宫产、新生儿低血糖分别12、13、9例,胎毛早破、胎盘早剥、新生儿窒息均1例。不良妊娠结局组IAA、ICA、GADA阳性占比高于正常妊娠结局组(P<0.05)。多因素回归分析显示,IAA(OR=3.180,95%CI 1.394~7.258)、ICA(OR=3.459,95%CI 1.592~7.517)、GADA(OR=3.219,95%CI 1.508~6.872)阳性是GDM不良妊娠结局的独立危险因素(P<0.05)。IAA、ICA、GADA联合检测GDM不良妊娠结局的AUC值高于IAA、ICA、GADA单项检测(Z=2.607、2.600、2.527,P<0.05)。结论IAA、ICA、GADA阳性是GDM患者不良妊娠结局危险因素,且联合检测有更高预测价值。ObjectiveTo analyze the predictive value of combined insulin autoantibody(IAA),islet cell antibody(ICA),and serum glutamic acid decarboxylase antibody(GADA)testing for pregnancy outcome in patients with gestational diabetes mellitus(GDM).MethodsOne hundred and twenty patients with GDM were retrospectively selected for the study,and were divided into a poor pregnancy outcome group and a normal pregnancy outcome group based on the pregnancy outcome at follow-up to delivery,which were 37 and 83 cases,respectively.The occurrence of adverse pregnancy outcomes in the study population was counted,and univariate and multivariate analyses of adverse pregnancy outcomes in GDM were performed.ResultsAdverse pregnancy outcomes were seen in 37 of the 120 study subjects,including 12,13 and 9 cases of macrosomia,caesarean section and neonatal hypoglycaemia,respectively,and 1 case of premature rupture of the foetal hairs,placenta previa and neonatal asphyxia.The percentage of IAA,ICA,and GADA positivity was higher in the adverse pregnancy outcome group than in the normal pregnancy outcome group(P<0.05).Multifactorial regression analysis showed that IAA(OR=3.180,95%CI 1.394-7.258),ICA(OR=3.459,95%CI 1.592-7.517),and GADA(OR=3.219,95%CI 1.508-6.872)positivity were independent risk factors for adverse pregnancy outcomes in GDM(P<0.05).The AUC values for the combined IAA,ICA,and GADA for the detection of adverse pregnancy outcomes in GDM were higher than those for IAA,ICA,and GADA alone(Z=2.607,2.600,and 2.527,P<0.05).ConclusionPositive IAA,ICA,and GADA are risk factors for adverse pregnancy outcomes in patients with GDM,and combined testing has a higher predictive value.

关 键 词：妊娠期糖尿病 妊娠结局 胰岛素自身抗体 胰岛细胞抗体 谷氨酸脱羧酶抗体 

分 类 号：R714.256[医药卫生—妇产科学]