GDM孕产妇外周血FPG、TyG、CRP水平评估不良妊娠结局价值  

Values of the levels of fasting plasma glucose,triglyceride,glucose and C-reactive protein of pregnant women with gestational diabetes mellitus for predicting their adverse pregnancy outcomes

作　　者：孙心旖 沈婷 曹晓轩 SUN Xinyi;SHEN Ting;CAO Xiaoxuan(Jiacing Maternity and Child Health Care Hospital,Jiaxing,Zhejiang Province,314000)

机构地区：[1]浙江省嘉兴市妇幼保健院,314000

出　　处：《中国计划生育学杂志》2025年第4期913-919,共7页Chinese Journal of Family Planning

摘　　要：目的:评估妊娠期糖尿病(GDM)孕产妇外周血空腹血糖(FPG)、甘油三酯葡萄糖(TyG)、C反应蛋白(CRP)预测不良妊娠结局价值。方法:回顾性收集2023年7月-2024年9月本院产前检查GDM孕产妇220例(GDM组)及健康产妇186例(正常对照组)临床资料,收集一般资料,血糖相关指标FBG、空腹胰岛素(FINS)、胰岛素抵抗的稳态模型评估(HOMA-IR),血脂相关指标总胆固醇(TC)、甘油三酯(TG)、脂蛋白(a)[Lp(a)]、TyG,肝功能白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT),平均动脉压,炎症相关指标CRP、降钙素原(PCT)、血清淀粉样蛋白A(SAA),不良分娩结局等。logistic分析影响GDM孕产妇不良妊娠结局的因素,采用受试者操作特征曲线(ROC)评估预测GDM孕产妇不良妊娠结局价值。结果:GDM组血清FBG、FINS、HOMA-IR、TyG和CRP均高于对照组,不良妊娠结局发生率(13.2%)高于对照组(3.2%)(P<0.05)。GDM组220例中妊娠结局良好组173例、不良组29例,不良组体质指数(入组时)、FBG(6.61±0.22 mmol/L)、TG、HOMA-IR、TyG(8.22±0.19)和CRP(11.45±0.65 mg/L)均高于良好组(5.72±0.44 mmol/L、7.94±0.24、9.74±0.93 mg/L)(均P<0.05)。logistic回归分析显示,FBG、TyG和CRP水平升高是影响GDM产妇不良妊娠结局的因素,ROC分析联合检测的AUC=0.973,敏感度100.0%,特异性87.2%,联合检测提高了预测效能。结论:GDM孕产妇外周血FPG、TyG、CRP均升高,联合检测预测患者不良妊娠结局的效能较好。Objective:To evaluate the values of the levels of fasting plasma glucose(FPG),triglyceride(TyG),glucose and C-reactive protein of pregnant women with gestational diabetes mellitus(GDM)for predicting their adverse pregnancy outcomes.Methods:220 pregnant women with GDM(in study group)and 186 healthy pregnant women(in control group)from July 2023 to September 2024 were collected retrospectively.The general information,the blood glucose related indicators,such as the levels of fasting blood glucose(FBG)and fasting insulin(FINS)and the homeostatic model assessment of insulin resistance(HOMA-IR)value,the levels of blood lipid related indicators,such as total cholesterol(TC),triglycerides(TG),lipoprotein a(Lpa)and TyG,the levels of liver function,such as albumin(ALB),aspartate aminotransferase(AST)and alanine aminotransferase(ALT),the mean arterial pressure value,the levels of inflammatory indicators,such as C-reactive protein(CRP),procalcitonin(PCT)and serum amyloid A(SAA),and the adverse pregnancy outcomes of the women in the two groups were recorded.Logistic analysis was used to identify the factors affecting the adverse pregnancy outcomes of the women with GDM.Receiver operating characteristic(ROC)curve was used to evaluate the value of these influence factors of the women with GDM for predicting their adverse pregnancy outcomes.Results:The serum levels of FBG,FINS,HOMA-IR,TyG and CRP of the women in the study group were significantly higher than those of the women in the control group.The incidence of the adverse pregnancy outcomes(3.2%)of the women in the study group was significantly higher than that(13.2%)of the women in the control group(P<0.05).Among 220women in the study group,there were 173cases with the normal pregnancy outcomes in group A and 29cases with the adverse pregnancy outcomes in group B.The body mass index(BMI)of the women in group B was significantly higher than that of the women in group A.The levels of FBG(6.61±0.22mmol/L),TyG(8.22±0.19)and CRP(11.45±0.65mg/L)of the women in group B were si

关 键 词：妊娠期糖尿病 空腹血糖 甘油三酯葡萄糖 C反应蛋白 不良妊娠结局 预测 

分 类 号：R714.256[医药卫生—妇产科学]