外周血脯氨酰4-羟化酶α2亚基水平与妊娠期糖尿病患者不良妊娠结局的关系  

Relationship between prolyl 4-hydroxylase subunit alpha 2 level in peripheral blood and adverse pregnancy outcome in patients with gestational diabetes mellitus

作　　者：曾江忠 毛蕾蕾 林蒙蒙 Zeng Jiangzhong;Mao Leilei;Lin Mengmeng(Department of Obstetrics and Gynecology,Wenzhou Central Hospital,Wenzhou 325000,China)

机构地区：[1]温州市中心医院妇产科,温州325000

出　　处：《中国医师进修杂志》2025年第4期311-317,共7页Chinese Journal of Postgraduates of Medicine

基　　金：温州市科学技术局项目(Y20240604)。

摘　　要：目的探讨外周血脯氨酰4-羟化酶α2亚基(P4HA2)水平与妊娠期糖尿病(GDM)患者不良妊娠结局的关系。方法回顾性收集2022年3月至2024年3月在温州市中心医院进行定期产检、分娩的120例GDM患者基线资料为GDM组;同期收集120例糖耐量正常(NGT)的孕妇基线资料为NGT组。比较两组血脂、血糖、外周血P4HA2等基线资料,采用Pearson相关性检验P4HA2与部分临床指标之间的相关性。统计GDM组妊娠结局,分为不良妊娠组32例与正常妊娠组88例,比较两组血脂、血糖、外周血P4HA2等基线资料,采用单因素、多因素Logistic回归分析筛查影响GDM患者发生不良妊娠结局的相关因素,绘制受试者工作特征(ROC)曲线分析外周血P4HA2对GDM患者不良妊娠结局的预测价值。结果GDM组空腹血糖、2 h血糖、1 h血糖、糖化血红蛋白(HbA 1c)、外周血P4HA2、胰岛素抵抗指数、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)水平均高于NGT组患者[(6.26±0.24)mmol/L比(4.33±0.15)mmol/L、(9.69±0.18)mmol/L比(7.41±0.19)mmol/L、(11.01±0.29)mmol/L比(7.10±0.27)mmol/L、(8.54±0.43)%比(5.05±0.61)%、(39.03±3.33)μg/L比(35.55±3.05)μg/L、2.50±0.34比1.95±0.33、(2.56±0.49)mmol/L比(2.08±0.37)mmol/L、(3.85±0.25)mmol/L比(3.26±0.30)mmol/L、(6.92±0.43)mmol/L比(6.25±0.43)mmol/L],高密度脂蛋白胆固醇(HDL-C)水平明显低于NGT组患者[(1.70±0.11)mmol/L比(1.87±0.22)mmol/L],差异有统计学意义(P<0.05)。经Pearson相关性检验显示,外周血P4HA2与空腹血糖、2 h血糖、1 h血糖、HbA 1c、胰岛素抵抗指数、TG、LDL-C、TC呈正相关关系(r>0,P<0.05);外周血P4HA2与HDL-C呈负相关关系(r<0,P<0.05)。不良妊娠组空腹血糖、2 h血糖、1 h血糖、胰岛素抵抗指数、外周血P4HA2、TC明显高于正常妊娠组[(6.35±0.22)mmol/L比(6.23±0.24)mmol/L、(9.78±0.25)mmol/L比(9.66±0.14)mmol/L、(11.12±0.33)mmol/L比(10.97±0.26)mmol/L、2.61±0.22比2.36±0.37、(41.20±3.62)μgObjectiveTo investigate the relationship between the level of prolyl 4-hydroxylase subunit alpha 2(P4HA2)in peripheral blood and the adverse pregnancy outcome in patients with gestational diabetes mellitus(GDM).MethodsA retrospective collection of baseline data was conducted on 120 GDM patients who underwent regular prenatal check ups and deliveries in Wenzhou Central Hospital from March 2022 to March 2024,serving as the GDM group.Baseline data from 120 pregnant women with normal glucose tolerance(NGT)during the same period were collected as the NGT group.Baseline data of blood lipids,blood glucose,and peripheral blood P4HA2 between the two groups were compared,and Pearson correlation test was used to determine the correlation between P4HA2 and some clinical indicators.Statistical analysis was conducted on the pregnancy outcomes of GDM patients,divided into the adverse pregnancy group(32 cases)and the normal pregnancy group(88 cases).Baseline data on blood lipids,blood glucose,and peripheral blood P4HA2 were compared between the two groups.Univariate and multivariate Logistic regression analysis were used to screen for factors affecting adverse pregnancy outcomes in GDM patients.Receiver operating characteristic(ROC)curves were also plotted to analyze the predictive value of peripheral blood P4HA2 for adverse pregnancy outcomes in GDM patients.ResultsCompared with the NGT group,the GDM group had higher levels of fasting glucose,2-h glucose,1-h glucose,glycosylated hemoglobin(HbA 1c),peripheral blood P4HA2,insulin resistance index,triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and total cholesterol(TC):(6.26±0.24)mmol/L vs.(4.33±0.15)mmol/L,(9.69±0.18)mmol/L vs.(7.41±0.19)mmol/L,(11.01±0.29)mmol/L vs.(7.10±0.27)mmol/L,(8.54±0.43)%vs.(5.05±0.61)%,(39.03±3.33)μg/L vs.(35.55±3.05)μg/L,2.50±0.34 vs.1.95±0.33,(2.56±0.49)mmol/L vs.(2.08±0.37)mmol/L,(3.85±0.25)mmol/L vs.(3.26±0.30)mmol/L,(6.92±0.43)mmol/L vs.(6.25±0.43)mmol/L,and significantly lower levels of high-density lipoprotein cho

关 键 词：糖尿病 妊娠 妊娠结局 脯氨酰4-羟化酶α2亚基 预测价值 

分 类 号：R714.256[医药卫生—妇产科学]