妊娠期糖尿病孕妇血清中VD、TBIL水平与炎症因子、妊娠结局的相关性  

An Analysis of the Correlation Between Serum Total Bilirubin and Vitamin D Levels with Inflammatory Factors and Pregnancy Outcomes in Pregnant Women with Gestational Diabetes Mellitus

作　　者：陶绘丞 孟文颖 李小庆 TAO Huicheng;MENG Wenying;LI Xiaoqing(Department of Obstetrics,Tongzhou Maternal&Child Health Hospital,Beijing 101100,China)

机构地区：[1]北京市通州区妇幼保健院产科,北京101100

出　　处：《标记免疫分析与临床》2025年第2期275-279,共5页Labeled Immunoassays and Clinical Medicine

基　　金：2023年度北京市通州区科技计划项目(编号:KJ2023CX068)。

摘　　要：目的探讨妊娠期糖尿病(GDM)患者血清维生素D(VD)、总胆红素(TBIL)的水平与炎症因子、妊娠结局的相关性。方法选取于2021年1月至2023年6月期间在我院接受诊治的184例GDM患者,依据妊娠结局分为2组:不良组(n=62)、良好组(n=122),并选190例同时期进行健康产检的孕妇作为健康组。酶联免疫吸附法检测血清TBIL、25(OH)D水平;采用Pearson相关分析GDM组血清TBIL、VD与血清炎症因子的关系;采用Logistic分析妊娠结局的影响因素;用ROC曲线分析TBIL、25(OH)D水平对妊娠结局的预测价值。结果与健康组相比,GDM组血清TBIL、25(OH)D水平均降低,CRP、TNF-α、IL-6水平均升高(P<0.05);Pearson分析GDM组血清TBIL、25(OH)D水平与CRP、TNF-α、IL-6均呈负相关(P<0.05);不良组血清TBIL、25(OH)D水平低于良好组(P<0.05);CRP、TNF-α、IL-6、TBIL、25(OH)D均为影响妊娠结局因素;血清TBIL、25(OH)D水平单独及联合预测GDM患者不良妊娠结局的曲线下面积(AUC)分别为0.866、0.739、0.923,与单独指标比较,二者联合预测的AUC显著升高(Z=2.042,P=0.041,Z=4.355,P<0.001)。结论GDM患者血清中TBIL、25(OH)D水平均下降,为妊娠不良的影响因素,二者联合对妊娠结局的预测具有更高的诊断价值。Objective To investigate the correlation between the expressions of vitamin D(VD),serum total bilirubin(TBIL)with inflammatory factors and pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods From January,2021 to June,2023,184 patients with GDM admitted to our hospital were included as the GDM group,and were further assigned into an adverse pregnancy outcome group(62 cases)and a good pregnancy outcome group(122 cases)based on their pregnancy outcomes.In addition,190 healthy pregnant women who underwent prenatal examinations in our hospital were included as the control group.Enzyme linked immunosorbent assay was applied to detect the expression levels of serum TBIL and 25(OH)D.Pearson correlation was applied to evaluate the relationship between serum TBIL,VD,interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)in patients with GDM.Logistic regression method was applied to identify factors that affected the occurrence of adverse pregnancy outcomes.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of TBIL and 25(OH)D levels for adverse pregnancy outcomes.Results Compared with the control group,the levels of serum TBIL and 25(OH)D were significantly lower in the GDM group,while the levels of CRP,TNF-α,and IL-6 were significantly higher(P<0.05).The expression of serum TBIL and 25(OH)D in GDM patients was negatively correlated with CRP,TNF-α,and IL-6(P<0.05).Compared with the good pregnancy outcome group,the adverse pregnancy outcome group had significantly lower levels of serum TBIL and 25(OH)D(P<0.05).ROC curve showed that the area under the curve(AUC)of serum TBIL and 25(OH)D levels alone,as well as in combination in predicting adverse pregnancy outcomes in GDM patients were 0.866,0.739,and 0.923,respectively.Compared with individual indicators,the AUC predicted by the combination of the two was significantly higher(Z=2.042,P=0.041,Z=4.355,P<0.001).Multiple logistic regression analysis showed that CRP,TNF-α,and IL-6 were

关 键 词：妊娠期糖尿病 维生素D 总胆红素 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]