妊娠期糖尿病孕妇LDL/ApoB比值与病情、妊娠结局的相关性分析  

Analysis of the correlation between LDL/ApoB ratio with disease severity and pregnancy outcomes in pregnant women with gestational diabetes mellitus

作　　者：鲁红艳 王雪影[1] 王小兰[1] 方紫微 于博 Lu Hongyan;Wang Xueying;Wang Xiaolan;Fang Ziwei;Yu Bo(Department of Perinatal Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院围产医学部,北京100026

出　　处：《保健医学研究与实践》2024年第11期61-66,共6页Health Medicine Research and Practice

基　　金：北京市卫生健康委员会卫生发展科研专项项目(2020-2Z-7083)。

摘　　要：目的探讨低密度脂蛋白(LDL)/载脂蛋白B(ApoB)比值与妊娠期糖尿病(GDM)患者病情、妊娠结局的关系,以期为临床决策的制定提供参考。方法选取2022年1月—2023年12月北京某医院收治的132例GDM患者作为研究对象。收集所有研究对象的临床资料,比较不同病情严重程度及妊娠结局患者的LDL/ApoB比值差异。采用Pearson相关分析探讨LDL/ApoB比值与病情分级的相关性,采用多因素logistic回归分析探讨GDM患者妊娠结局的影响因素。结果A2级GDM患者LDL/ApoB比值(2.18±0.27)高于A1级(1.57±0.23),差异有统计学意义(P<0.05)。Pearson相关分析显示,GDM患者LDL/ApoB比值与病情分级呈正相关(r=0.587,P<0.001)。不良妊娠结局组GDM患者LDL/ApoB比值(2.56±0.37)高于良好妊娠结局组(1.48±0.16),差异有统计学意义(P<0.05)。LDL/ApoB比值评估GDM患者妊娠结局的曲线下面积(AUC)(95%CI)为0.902(0.857~0.952),特异度为85.92%,灵敏度为86.38%,LDL/ApoB比值的最佳截点值为1.92。单因素分析显示,不良妊娠结局组患者的胰岛素抵抗指数(HOMA-IR)、分娩方式为剖宫产的人数比例、孕前高血压的人数比例均高于良好妊娠结局组(P<0.05)。logistic逐步回归分析结果显示,HOMA-IR指数升高(OR=2.416,95%CI:1.358~4.298),LDL/ApoB比值≥1.92(OR=3.093,95%CI:1.652~5.790)是GDM患者出现不良妊娠结局的独立影响因素(P<0.05)。结论LDL/ApoB比值在GDM患者中高表达,且与病情及妊娠结局有关,其可有望成为评估GDM患者妊娠结局的潜在标志物。Objective To investigate the relationship between the low-density lipoprotein/apolipoprotein B(LDL/ApoB)ratio with disease severity and pregnancy outcomes in patients with gestational diabetes mellitus(GDM),providing a reference for clinical decisionmaking.Methods A total of 132 GDM patients admitted to a hospital in Beijing from January 2022 to December 2023 were selected as the study participants.Clinical data were collected,and differences in LDL/ApoB ratios were compared among patients with varying disease severity and pregnancy outcomes.Pearson correlation analysis was used to explore the relationship between the LDL/ApoB ratio and Priscilla White classification.Multivariate logistic regression was employed to identify influencing factors for pregnancy outcomes in GDM patients.Results The LDL/ApoB ratio in A2-classified GDM patients(2.18±0.27)was significantly higher than that in A1-classified patients(1.57±0.23;P<0.05).Pearson correlation analysis revealed a positive correlation between the LDL/ApoB ratio and Priscilla White classification(r=0.587,P<0.001).The LDL/ApoB ratio in the adverse pregnancy outcome group(2.56±0.37)was significantly higher than that in the favorable pregnancy outcome group(1.48±0.16;P<0.05).The area under the curve(AUC)(95%CI)for the LDL/ApoB ratio in predicting pregnancy outcomes was 0.902(0.857-0.952),with a specificity of 85.92%and sensitivity of 86.38%,and the optimal cutoff value for the LDL/ApoB ratio was 1.92.Univariate analysis indicated that the adverse pregnancy outcome group had higher homeostasis model assessment of insulin resistance(HOMA-IR)indices,higher rates of cesarean delivery,and higher proportions of pre-pregnancy hypertension compared to the favorable outcome group(P<0.05).Stepwise logistic regression analysis indicated that elevated HOMA-IR(OR=2.416,95%CI:1.358-4.298)and LDL/ApoB ratio≥1.92(OR=3.093,95%CI:1.652-5.790)were independent risk factors for adverse pregnancy outcomes in GDM patients(P<0.05).Conclusion The LDL/ApoB ratio is highly expressed in G

关 键 词：妊娠期糖尿病 病情 妊娠结局 低密度脂蛋白/载脂蛋白B比值 

分 类 号：R714.25[医药卫生—妇产科学]