妊娠早期血清硒水平预测妊娠期糖尿病的临床研究  

Research on the Correlation Between Serum Selenium Level in Early Pregnancy and Gestational Diabetes Mellitus

作　　者：杨燕 张春兰[2] 陈凯杰 杨金妹 YANG Yan;ZHANG Chunlan;CHEN Kaijie;YANG Jinmei(Basic Nursing Teaching and Research Section,Chuzhou City Vocational College;Obstetrics Department,the First People′s Hospital of Chuzhou;Obstetrics Department,Chuzhou Integrated Traditional Chinese and Western Medicine Hospital,Chuzhou 239000 China)

机构地区：[1]滁州城市职业学院基础护理教研室 [2]滁州市第一人民医院产科 [3]滁州中西医结合医院产科,安徽滁州239000

出　　处：《锦州医科大学学报》2025年第1期99-103,共5页Journal of Jinzhou Medical University

基　　金：安徽省高校科研项目(自然科学类),项目编号:2022AH052877;2022年度校级科研项目自然重点项目,项目编号:2022zkzd01。

摘　　要：目的探究妊娠早期血清硒水平和妊娠期糖尿病(gestational diabetes mellitus,GDM)的相关性。方法选取2021年1月至2022年5月于滁州中西医结合医院产科门诊首次确认妊娠的孕妇作为研究对象,检测所有孕妇妊娠早期(孕6~14周)的血清硒水平及其他相关指标,将其按是否确诊GDM分为GDM组和对照组。比较两组相关资料,采用Logistic多因素回归模型分析孕妇发生GDM的影响因素,并使用受试者工作特征(receiver operating characteristic,ROC)曲线分析血清硒水平对GDM的预测价值。结果最终纳入分析的340例孕妇中,GDM发病率为21.18%(GDM组72例、对照组268例)。GDM组的年龄、孕前体质指数(body mass index,BMI)、经产妇占比及妊娠早期空腹血糖(fasting blood glucose,FPG)、糖化血红蛋白(glycated hemoglobin A1c,HbA1c)、空腹胰岛素(fasting insulin,FINS)水平均明显高于对照组,差异有统计学意义(P<0.05)。GDM组妊娠早期血清硒水平则较对照组低,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,年龄、孕前BMI(OR=1.190,95%CI:1.025~1.494)、FPG(OR=1.408,95%CI:1.121~1.767)、HbA1c(OR=2.125,95%CI:1.237~3.651)和血清硒水平(OR=0.381,95%CI:0.222~0.654)均是孕妇发生GDM的影响因素,差异有统计学意义(P<0.05)。ROC曲线显示,妊娠早期血清硒水平预测GDM的曲线下面积(area under curve,AUC)为0.932,敏感度、特异度分别为83.33%、91.42%。结论妊娠早期血清硒水平是GDM的独立影响因素,提高其水平可降低GDM的发生风险,检测血清硒水平对预测GDM的发生具有较高应用价值。Objective To explore the correlation between serum selenium level in early pregnancy and gestational diabetes mellitus(GDM).Methods Pregnant women who were first confirmed pregnant in the obstetrics clinic of our hospital from January 2021 to May 2022 were selected as the study objects.Serum selenium levels and other related indicators in the early gestation period(6-14 weeks of gestation)of all pregnant women were detected,and they were divided into GDM group and control group according to whether they were diagnosed with GDM.The relevant data of the two groups were compared,the influencing factors of GDM in pregnant women were analyzed by Logistic multivariate regression model,and the predictive value of serum selenium level to GDM was analyzed by receiver operating characteristic(ROC)curve.Results Among the 340 pregnant women included in the analysis,the incidence of GDM was 21.18%(72 in GDM group and 268 in control group).The age,pre-pregnancy body mass index(BMI),proportion of multipara,fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c)and fasting insulin(FINS)levels in GDM group were significantly higher than those in control group(P<0.05).The serum selenium level in the GDM group was lower than that in the control group(P<0.05).Logistic multivariate regression analysis showed that age,pre-pregnancy BMI(OR=1.190,95%CI:1.025-1.494),FPG(OR=1.408,95%CI:1.121-1.767),HbA1c(OR=2.125,95%CI:1.237-3.651)and serum selenium level(OR=0.381,95%CI:0.222-0.654)were the influencing factors of GDM in pregnant women(P<0.05).ROC curve showed that the area under the curve(AUC)of serum selenium level in early pregnancy to predict GDM was 0.932,the sensitivity and specificity were 83.33%and 91.42%,respectively.Conclusion Serum selenium level in early pregnancy is an independent factor of GDM,and increasing its level can reduce the risk of GDM.Detection of serum selenium level has high application value in predicting the occurrence of GDM.

关 键 词：硒元素 妊娠 妊娠期糖尿病 

分 类 号：R714.256[医药卫生—妇产科学]