GDM患者血清ANGPTL2、ANGPTL4水平与胰岛素抵抗及母婴结局的关系  

Correlation between the levels of the serum angiopoietin-like 2 and angiopoietin-like 4 of pregnant women with gestational diabetes mellitus and their insulin resistance and maternal-infant outcomes

作　　者：刘循灿 董珊珊 刘娜 董燕 冷慧敏[2] LIU Xuncan;DONG Shanshan;LIU Na;DONG Yan;LENG Huimin(Xingtai Central Hospital,Xingtai,Hebei Province,054000;Qinhuangdao Harbor Hospital,Qinhuangdao,Hebei Province)

机构地区：[1]河北省邢台市中心医院,054000 [2]河北省秦皇岛市海港医院

出　　处：《中国计划生育学杂志》2025年第3期732-735,740,共5页Chinese Journal of Family Planning

基　　金：河北省卫生健康委办公室医学科学研究课题计划(20221624)。

摘　　要：目的:探讨妊娠期糖尿病(GDM)患者血清血管生成素蛋白2(ANGPTL2)、血管生成素蛋白4(ANGPTL4)水平与胰岛素抵抗及母婴结局关系。方法:选取2021年8月-2023年12月本院收治的GDM患者108例为GDM组,健康孕妇110例为对照组,比较两组糖脂代谢指标、胰岛素抵抗指数(HOMA-IR)、血清ANGPTL2及ANGPTL4水平,Pearson相关性分析血清ANGPTL2、ANGPTL4水平与HOMA-IR的相关性;根据GDM患者母婴结局分为良好结局组与不良结局组,分析血清ANGPTL2、ANGPTL4对母婴结局的预测价值。结果:GDM组FBG、HbA1c、TG、TC、LDL-C、FINS、HOMA-IR及血清ANGPTL2水平(3.51±0.42 ng/ml)均高于对照组(3.36±0.35 ng/ml),HDL-C、ANGPTL4水平(5.78±1.37 ng/ml)低于对照组(10.69±2.20 ng/ml),HOMA-IR与血清ANGPTL2呈正相关,与ANGPTL4水平呈负相关(均P<0.05)。随访出现不良母婴结局31例,不良结局患者血清ANGPTL2水平高于良好结局患者,ANGPTL4水平低于良好结局患者(均P<0.05)。受试者工作特征曲线分析,血清ANGPTL2、ANGPTL4预测母婴结局的最佳截断值分别为3.590 ng/ml、5.745 ng/ml,曲线下面积(AUC)分别为0.797、0.732,2项联合预测的AUC(0.880)及敏感度(96.8%)更高(P<0.05)。结论:GDM患者血清ANGPTL2、ANGPTL4表达水平发生异常,两者均与胰岛素抵抗有关,且血清ANGPTL2联合ANGPTL4预测GDM母婴结局价值较好。Objective:To observe the correlation between the levels of serum angiopoietin-like 2(ANGPTL2)and angiopoietin-like 4(ANGPTL4)of pregnant women with gestational diabetes mellitus(GDM)and their insulin resistance and maternal-infant outcomes.Methods:A total of 108 pregnant women with GDM were selected in study group.Meanwhile,11o healthy pregnant women were selected in control group.The glucose and lipid metabolism indicators levels,the homeostasis model assessment of insulin resistance(HOMA-IR)value,and the levels of serum ANGPTL2 and ANGPTL4 of the women were compared between the two groups.The correlation between the serum ANGPTL2 and ANGPTL4 levels of the women with GDM and their HOMA-IR value was analyzed by Pearson correlation analysis.According to the maternal-infant outcomes,the women with GDM were divided into group A(women with the normal maternal-infant outcomes)and group B(women with the adverse maternal-infant outcomes).The predictive values of the serum ANGPTL2 and ANGPTL4 levels of the women with GDM for their maternal-infant outcomes were analyzed.Results:The levels of FBG,HbA1c,TG,TC,LDL-C and FINS,and the HOMA-IR value of the women in the study group were significantly higher than those of the women in the control group.The level of serum ANGPTL2(3.51±0.42 ng/ml)of the women in the study group was significantly higher than that(3.36±0.35 ng/ml)of the women in the control group.The HDL-C level of the women in the study group was significantly lower than that of the women in the control group.The level of serum ANGPTL4 level(5.78±1.37 ng/ml)of the women in the study group was significantly lower than that(10.69±2.20 ng/ml)of the women in the control group.The HOMA-IR value of the women with GDM was positively correlated with their serum ANGPTL2 level,and was negatively correlated with their ANGPTL4 level(all P<0.05).There were 31 women with the adverse maternal-infant outcomes during the follow-up.The serum level of ANGPTL2 of the women in group B was significantly higher than that of the women

关 键 词：妊娠期糖尿病 血管生成素蛋白2 血管生成素蛋白4 胰岛素抵抗 相关性 母婴不良结局 预测 

分 类 号：R71[医药卫生—妇产科学]