妊娠期糖尿病病人血清HSP70、HMGB1水平与胰岛素抵抗及妊娠结局的关系研究  

Relationship between serum HSP70,HMGB1 levels and insulin resistance and pregnancy outcomes in patients with gestational diabetes mellitus

作　　者：朱丽娟 王盼盼 张安红[1] ZHU Lijuan;WANG Panpan;ZHANG Anhong(Department of Obstetrics and Gynecology,Nanjing Jiangning Hospital,Nanjing,Jiangsu 211100,China)

机构地区：[1]南京市江宁医院妇产科,江苏南京211100

出　　处：《安徽医药》2025年第4期828-832,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究妊娠期糖尿病(GDM)病人血清热休克蛋白70(HSP70)、高迁移率族蛋白B1(HMGB1)水平与胰岛素抵抗(IR)及妊娠结局的关系。方法选取2021年5月至2022年5月于南京市江宁医院进行产检的并诊断为GDM的孕妇280例为研究对象,作为GDM组,另选同期非糖尿病正常妊娠孕妇280例作为对照组,收集受试者实验室指标及临床资料,随访受试者6个月,记录胎儿窘迫、巨大儿、羊水过多、产后出血、胎膜早破等常见妊娠不良结局,比较GDM组及对照组不良妊娠结局的发生率;血清中HSP70、HMGB1表达水平与IR及妊娠结局的相关性采用Pearson法分析。结果GDM组空腹血糖(FPG)、餐后1 h血糖(1 h PG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、HSP70[(0.35±0.13)μg/L]及HMGB1[(83.64±18.95)μg/L]水平均显著高于对照组[(0.26±0.08)μg/L、(71.29±13.67)μg/L],高密度脂蛋白胆固醇(HDL-C)显著低于对照组(P<0.05);血清HSP70与FPG、1 h PG、2 h PG、FINS及HOMA-IR均呈正相关(r=0.44、0.37、0.40、0.63、0.59,P<0.05),血清HMGB1与FPG、1 h PG、2 h PG、FINS及HOMA-IR均呈正相关(r=0.39、0.44、0.51、0.58、0.62,P<0.05);GDM组不良妊娠结局发生率(40.00%,112/280)显著高于对照组(4.29%,12/280)(P<0.05);妊娠结局不良GDM病人FPG、1 h PG、2 h PG、FINS、HOMA-IR及血清HSP70、HMGB1均显著高于妊娠结局良好GDM病人(P<0.05);血清HSP70与胎儿窘迫、巨大儿、羊水过多、产后出血、胎膜早破均呈正相关(r=0.43、0.54、0.48、0.61、0.40,P<0.05);血清HMGB1与胎儿窘迫、巨大儿、羊水过多、产后出血、胎膜早破均呈正相关(r=0.66、0.71、0.58、0.49、0.55,P<0.05);多因素logistic回归分析结果显示,HOMA-IR、HSP70、HMGB1均是GDM病人出现不良妊娠结局的危险因素。结论GDM病人血清HSP70、HMGB1高表达,且HSP70、HMGB1均与GDM病人IR及妊娠结局显著相关。Objective To investigate the relationship between serum levels of heat shock protein 70(HSP70),high mobility group protein B1(HMGB1)and insulin resistance(IR)and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 280 pregnant women diagnosed as GDM who underwent prenatal examination in Nanjing Jiangning Hospital from May 2021 to May 2022 were selected as the study subjects(GDM group),while 280 non-diabetic normal pregnant women examined during the same period were selected as the control group.The laboratory indicators and clinical data of the subjects were collected,and the subjects were followed up for 6 months,the common adverse pregnancy outcomes recorded,such as fetal distress,macrosomia,polyhydramnios,postpartum hemorrhage,and premature rupture of membranes.The incidences of adverse pregnancy outcomes were compared between GDM group and control group;the correlation between the expressions of HSP70 and HMGB1 in serum and IR and pregnancy outcomes was analyzed by Pearson Correlation.Results The expression levels of fasting blood glucose(FPG),1 h postprandial blood glucose(1 h PG),2 h postprandial blood glucose(2 h PG),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),insulin resistance(HOMA-IR),HSP70[(0.35±0.13)μg/L vs.(0.26±0.08)μg/L]and HMGB1[(83.64±18.95)μg/L vs.(71.29±13.67)μg/L]were significant higher in GDM group than control group,while the level of high density lipoprotein cholesterol(HDL-C)was obviously lower than control group(P<0.05).Serum HSP70 was positively correlated with FPG,1h PG,2h PG,FINS and HOMA-IR(r=0.44,0.37,0.40,0.63,0.59,respectively;P<0.05),and serum HMGB1 was positively correlated with FPG,1h PG,2h PG,FINS and HOMA-IR(r=0.39,0.44,0.51,0.58,0.62,respectively;P<0.05).The incidence of adverse pregnancy outcomes in GDM group(40.00%,112/280)was obviously higher than that in control group(4.29%,12/280)(P<0.05);levels of FPG,1 h PG,2 h PG,FINS,HOMA-IR,serum HSP70 and HMGB1 in GDM patients

关 键 词：妊娠期糖尿病 热休克蛋白70 高迁移率族蛋白B1 胰岛素抵抗 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]