妊娠期糖尿病患者血清miRNA-21、miRNA-31水平与凝血功能、炎症反应及妊娠结局的关系  

Relationship between serum miRNA-21 and miRNA-31 levels,coagulation function,inflammatory response,and pregnancy outcomes in patients with gestational diabetes mellitus

作　　者：国晓 孟祥瑞 白晓蔚 刘娜 梁媛哲 GUO Xiao;MENG Xiang-rui;BAI Xiao-wei(Department of Delivery Room,Xingtai Central Hospital,Xingtai Hebei 054000,China;Department of Gynecology,Xingtai Central Hospital,Xingtai Hebei 054000,China)

机构地区：[1]邢台市中心医院产房,河北邢台054000 [2]邢台市中心医院妇科,河北邢台054000

出　　处：《临床和实验医学杂志》2025年第5期511-515,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省2021年度医学科学研究课题计划(编号:20211131)。

摘　　要：目的探究妊娠期糖尿病患者血清微小RNA(miRNA)-21、miRNA-31水平与凝血功能、炎症反应及妊娠结局的关系。方法回顾性选取2018年2月至2024年4月在邢台市中心医院进行产检并生产的378例妊娠期糖尿病患者为研究对象,并根据其妊娠结局进行分组:妊娠结局不良组(n=58)和妊娠结局正常组(n=320)。比较组间的血糖指标[口服葡萄糖耐量试验1小时血糖(1 h OGTT)、2 h OGTT、糖化血红蛋白(GHb)、胰岛素抵抗指数(HOMA-IR)]、凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)]、炎症反应[脂肪酸结合蛋白4(FABP4)、白细胞介素6(IL-6)、骨保护素、脂联素]及其血清miRNA-21、miRNA-31水平,并探究miRNA-21、miRNA-31水平与其凝血指标、炎症指标的关系。结果两组患者的空腹OGTT、1 h OGTT、2 h OGTT、GHb、HOMA-IR比较,差异均无统计学意义(P>0.05)。妊娠结局不良组患者的PT、APTT分别为(10.31±1.12)、(23.66±2.46)s,均低于妊娠结局正常组[(11.66±2.45)、(27.99±4.15)s],FIB、D-D分别为(4.91±0.46)g/L、(0.98±0.12)μg/L,均高于妊娠结局正常组[(3.88±0.54)g/L、(0.81±0.08)μg/L],差异均有统计学意义(P<0.05)。妊娠结局不良组患者的FABP4、IL-6、骨保护素水平分别为(6.45±1.26)、(361.03±18.46)、0.04(0.02,0.06)pg/L,均高于妊娠结局正常组[(4.33±1.16)、(344.15±22.15)、0.02(0.01,0.04)pg/L],脂联素水平为0.02(0.01,0.04)pg/L,低于妊娠结局正常组[0.03(0.01,0.04)pg/L],差异均有统计学意义(P<0.05)。妊娠结局不良组患者的血清miRNA-21为0.78±0.13,低于妊娠结局正常组(1.23±0.33),miRNA-31水平为2.44±0.66,高于妊娠结局正常组(1.56±0.51),差异均有统计学意义(P<0.05)。经相关性分析,miRNA-21与PT、APTT、脂联素均呈正相关(P<0.05),与FIB、D-D、FABP4、IL-6和骨保护素均呈负相关(P<0.05)。miRNA-31与PT、APTT和脂联素均呈负相关(P<0.05),与FIB、D-D、FABP4、IL-6和骨保�Objective To investigate the relationship between serum levels of microRNA(miRNA)-21 and miRNA-31,coagulation function,inflammatory response,and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 378 patients with gestational diabetes mellitus who underwent prenatal examination and delivery in Xingtai Central Hospital from February 2018 to April 2024 were retrospectively selected as the research objects and divided into two groups according to their pregnancy outcomes:the poor pregnancy outcome group(n=58)and the normal pregnancy outcome group(n=320).The blood glucose indexes[oral glucose tolerance test 1 hour blood glucose(1 h OGTT),2 h OGTT,glycosylated hemoglobin(GHb),insulin resistance index(HOMA-IR)],coagulation indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)],inflammatory response[fatty acid binding protein 4(FABP4),interleukin 6(IL-6),osteoprotegerin,adiponectin]and serum miRNA-21,miRNA-31 levels were compared between the two groups,and the relationship between miRNA-21,miRNA-31 levels,and these indicators were explored.Results There were no statistically significant differences in fasting OGTT,1-hour OGTT,2-hour OGTT,glycosylated hemoglobin,and insulin resistance index between the two groups(P>0.05).The PT and APTT in the poor pregnancy outcome group were(10.31±1.12)and(23.66±2.46)s,respectively,which were lower than those in the normal pregnancy outcome group[(11.66±2.45)and(27.99±4.15)s],FIB and D-D were(4.91±0.46)g/L and(0.98±0.12)μg/L,respectively,which were higher than those in the normal pregnancy outcome group[(3.88±0.54)g/L and(0.81±0.08)μg/L],the differences were statistically significant(P<0.05).The levels of FABP4,IL-6 and osteoprotegerin in the poor pregnancy outcome group were(6.45±1.26),(361.03±18.46)and 0.04(0.02,0.06)pg/L,respectively,which were higher than those in the normal pregnancy outcome group[(4.33±1.16),(344.15±22.15)and 0.02(0.01,0.04)pg/L],and the level of adiponectin was 0

关 键 词：妊娠期糖尿病 微小RNA-21 微小RNA-31 凝血指标 炎症反应 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]