摘要
目的 探究妊娠糖尿病患者血清中白脂素(Asprosin)水平的变化及其临床意义.方法 选取2020年9月至2021年12月同济大学附属第一妇婴保健院收治的50例妊娠糖尿病患者作为观察组,另选50名来本院进行产检的健康孕妇作为对照组.采用酶联免疫吸附试验法检测血清Asprosin水平.采用自动电化学发光免疫分析仪检测空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、C反应蛋白(CRP),并计算胰岛素抵抗指数(HOMA-IR),采用糖化血红蛋白检测仪检测糖化血红蛋白(HbA1c).比较两组研究对象血清Asprosin、FPG、FINS、HOMA-IR、CRP、甘油三酯、HDL-C、HbA1c 水平,分析血清 Asprosin 与 FPG、FINS、HOMA-IR、CRP、甘油三酯、HDL-C、HbA1c水平的相关性,分析妊娠糖尿病发生的危险因素,采用受试者工作特征(ROC)曲线分析血清Asprosin对妊娠糖尿病的诊断效能.结果 观察组血清Asprosin、FPG、FINS、HOMA-IR、CRP、甘油三酯、HbA1c水平分别为(320.41± 79.18)pg/mL、(6.82±0.98)mmol/L、13.54±4.95)mU/L、3.18±0.82、(0.87±0.29)mg/L、(2.45±0.87)mmol/L、(6.57±0.62)％,均明显高于对照组[(212.30±63.28)pg/mL、(4.57±0.34)mmol/L、(9.82±4.67)mU/L、1.22±0.50、(0.38±0.18)mg/L、(1.71±0.28)mmol/L、(5.61±0.39)％],HDL-C 水平为(1.59±0.39)mmol/L,明显低于对照组[(1.96±0.45)mmol/L],差异均有统计学意义(P＜0.05).经Pearson结果显示,妊娠糖尿病患者血清Asprosin与FPG、FINS、HOMA-IR、CRP、甘油三酯、HbA1c 呈正相关性(P＜0.05);与 HDL-C 呈负相关(P＜0.05).Logistics 回归分析显示,Asprosin、FPG、FINS、HOMA-IR、甘油三酯、HDL-C、HbA1 c均是妊娠糖尿病发生的危险因素(P＜0.05).ROC曲线显示,当截断值为297.16 pg/mL,血清Asprosin诊断妊娠糖尿病的敏感度为86.59％、特异度为90.52％,曲线下面积(AUC)值为0.890(95％CI:0.852～0.947),约登指数为0.75.结论 妊娠糖尿病孕妇的血清Asprosin水平明显高于正常孕妇,血清Asprosin水平对妊娠糖尿病有良好的诊断效能.
Abstract
Objective To explore the changes and clinical significance of serum Asprosin level in patients with gestational diabetes.Methods Fifty patients with gestational diabetes admitted to Shanghai First Maternity and Infant Hospital from September 2020 to December 2021 were selected as the observation group of this study,and another 50 healthy people who came to our hospital for physical examination were selected as the control group of this study.The level of serum Asposin was detected using enzyme-linked immunosorbent assay.Fasting blood glucose(FPG),fasting insulin(FINS),triglycerides,high-density lipoprotein cholesterol(HDL-C),and C-reactive protein(CRP)were detected using automatic electrochemiluminescence immunoassay analyzer,and insulin resistance index(HOMA-IR)was calculated.Hemoglobin(HbA1c)was detected using glycated hemoglobin detector.The levels of Asposin,FPG,FINS,HOMA-IR,CRP,triglycerides,HDL-C,and HbA1c of the two groups were compared,and the correlation between serum Asprosin and FPG,FINS,HOMA-IR,CRP,triglycerides,HDL-C,and HbA1c.The risk factors of diabetes in pregnancy was analyzed and the diagnostic efficacy of serum Asprosin level for diabetes in pregnancy was analyzed by receiver operating characteristic(ROC).Results The levels of serum Asposin,FPG,FINS,HOMA-IR,CRP,triglycerides,and HbA1c in the observation group were(320.41±79.18)pg/mL,(6.82±0.98)mmol/L,and 13.54±4.95)mU/L,3.18±0.82,(0.87 ±0.29)mg/L,(2.45±0.87)mmol/L,(6.57±0.62)％,respectively,which were significantly higher than those in the control group[(212.30±63.28)pg/L,(4.57±0.34)mmol/L,(9.82±4.67)mU/L,1.22±0.50,(0.38±0.18)mg/L,(1.71±0.28)mmol/L,(5.61±0.39)％],and the level of HDL-C was(1.59±0.39)mmol/L,which was significantly lower than that in the control group[(1.96 ±0.45)mmol/L,the differences were statistically significant(P＜0.05).Pearsons results showed that the serum Asprosin in patients with ges-tational diabetes was positively correlated with FPG,FINS,HOMA-IR,CRP,triglyceride,and HbA1c(P＜0.05);there was a negative cor-relation with HDL-C(P＜0.05).Logistic regression analysis showed that Asprosin,FPG,FINS,HOMA-IR,triglyceride,HDL-C,HbA1c were all risk factors for diabetes in pregnancy(P＜0.05).The ROC curve showed that when the cut-off value was 297.16 pg/mL,the sensitivity,specificity,area under the curve(AUC),and Yodon index of serum Asprosin in the diagnosis of gestational diabetes were 86.59％,90.52％,0.890(95％CI:0.852-0.947),and 0.75 respectively.Conclusion The serum Asprosin level of pregnant women with diabetes during pregnancy is significantly higher than that of normal pregnant women.The serum Asprosin level has good diagnostic efficacy for diabetes during pregnancy.
基金项目
上海市"医学科技创新行动计划"基金辅助项目(21ZR1438300)
维普
万方数据