Predictive value of serum Ghrelin and VEGF-A levels in early onset fetal growth restriction in patients with gestational diabetes mellitus
Objective To investigate the predictive value of serum levels of Ghrelin and vascular endothelial growth factor-A(VEGF-A)in early-onset fetal growth restriction(FGR)in patients with gestational dia-betes mellitus(GDM).Methods GDM patients who underwent prenatal examination and delivered in Hainan women's and children's medical center from March 2020 to March 2022 were selected asthe study objects,and could be divided into FGR group(n=26),normal group(n=82)and macrosomia group(n=18)according to fetal weight.Serum Ghrelin and VEGF-A levels were compared among the three3 groups,and Pearson correlation coefficient method was used to analyze the correlation between the two 2 indexes and fetal weight,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Ghrelin and VEGF-A on the occurrence of early-onset FGR in pregnant women with GDM.Results The total incidence of adverse pregnancy outcome in 131 GDM women was 37.40％(49/131),in-cluding 18 macrosomia cases and 26 FGR cases.The fasting blood glucose level and the proportion of ce-sarean section in normal group were lower than those in FGR group and macrosomia group,but there was no significant difference between FGR group and macrosomia group(P＞0.05).Compared with macroso-mia groups,the serum Ghrelin level in FGR group and normal group was higher than normal group,the VEGF-A level in FGR group and normal group was lower,and the VEGF-A level in FGR group was lower than normal group(P＜0.05).Pearson correlation analysis showed that serum Ghrelin was negatively correlated with fetal birth weight(r=-0.677,P＜0.05),and VEGF-A was positively correlated with fe-tal birth weight(r=0.690,P＜0.05).ROC curve showed that the AUC of serum Ghrelin and VEGF-A alone in predicting the occurrence of early-onset FGR in pregnant women with GDM was 0.672 and 0.755,respectively,and the AUC of combined prediction was 0.848.The combined prediction efficiency was bet-ter than that of single prediction(P＜0.05).Conclusion Serum Ghrelin and VEGF-A levels in GMD pregnant women are correlated with fetal weight,which are predictive markers of early-onset FGR,and their combined prediction of early-onset FGR in pregnant women with GMD has higher clinical value.
万方数据
维普
