Changes in serum NOV/CCN3 levels in mid-to late-term pregnant women and their association with gesta-tional diabetes mellitus and pregnancy outcome
郑文静 1储祥玲 1吴雨琼 1张敏 2储小宏 3张楠 1胡红琳1
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作者信息
1. 安徽医科大学第一附属医院内分泌科(安徽 合肥 230000)
2. 安徽医科大学第一附属医院检验科(安徽 合肥 230000)
3. 安徽医科大学第一附属医院内分泌实验室(安徽 合肥 230000)
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摘要
目的 探讨中晚期孕妇血清NOV/CCN3水平变化,并分析其与妊娠期糖尿病(gestational dia-betes mellitus,GDM)及妊娠结局的关系.方法 根据口服葡萄糖耐量实验(oral glucose tolerance test,OGTT)结果,将252例妊娠女性分为GDM组与对照组.根据妊娠前体质量指数水平及妊娠结局情况将GDM组进行分组.收集所有研究对象临床资料,比较组间一般资料、生化指标及NOV/CCN3水平的差异.结果 GDM组血清NOV/CCN3水平高于对照组(P<0.001).Spearman相关分析结果表明血清NOV/CCN3与妊娠前体质量、妊娠前体质量指数、胰岛素抵抗指数、总胆固醇呈正相关,与胰岛素敏感指数呈负相关(P<0.05).logistic回归分析结果表明,NOV/CCN3是GDM发生的独立危险因素[OR=1.097,95%CI(1.020～1.179),P=0.013],且是GDM患者发生不良妊娠结局的独立危险因素[OR=1.032,95%CI(1.020～1.045),P<0.001],ROC分析结果显示曲线下面积(area under the curve,AUC)分别为0.840、0.784(P<0.05).结论 中晚期孕妇血清NOV/CCN3水平与肥胖、胰岛素抵抗及糖脂代谢相关,参与GDM发生发展,为评估中晚期孕妇发生GDM及GDM患者妊娠结局提供新的思路.
Abstract
Objective To investigate alterations in serum NOV/CCN3 levels among women during mid-to-late pregnancy and elucidate its association with gestational diabetes mellitus(GDM)and pregnancy outcomes.Methods Based on the results of an oral glucose tolerance test(OGTT),we categorized 252 pregnant women into two groups:the GDM group and the control group.Within the GDM group,participants were further stratified based on pre-pregnancy body mass index levels and pregnancy outcomes.We collected clinical data for all study subjects and compared differences in general information,biochemical indicators,as well as NOV/CCN3 levels between these groups.Results The serum levels of NOV/CCN3 in the GDM group were significantly higher compared to those in the control group(P<0.001).Spearman correlation analysis revealed a positive association between serum NOV/CCN3 and pre-pregnancy body weight,pre-pregnancy body mass index,insulin resistance index,and total cholesterol;while a negative correlation was observed with insulin sensitivity index(P<0.05).Logistic regression analysis demonstrated that NOV/CCN3 is an independent risk factor for the development of GDM[OR=1.097,95%CI(1.020～1.179),P=0.013],as well as adverse pregnancy outcomes in GDM patients[OR=1.032,95%CI(1.020～1.045),P<0.001].ROC analysis indicated AUCs of 0.840 and 0.784 for these associations respectively(P<0.05).Conclusions Serum levels of NOV/CCN3 in pregnant women at mid-to late-stage are associated with obesity,insulin resistance,and glucose-lipid metabolism,suggesting a potential role of NOV/CCN3 in glycolipid metabolism during gestational diabetes mellitus(GDM).These findings provide novel insights for assessing the occurrence of GDM and predicting pregnancy outcomes in mid-to late-stage pregnancies.
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