Objective To study the expression of serum endothelial cell specific molecule(Endocan)and Isthmin1(ISM1)in patients with gestational diabetes mellitus(GDM)and their relationship with adverse pregnancy outcomes.Meth-ods A total of 94 patients with GDM diagnosed and treated in the Department of Obstetrics,the Fifth Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2023 were selected as GDM group.According to the pregnancy outcome,they were divided into poor prognosis subgroup(36 cases)and good prognosis subgroup(58 cases),48 healthy pregnant women who underwent physical examinations during the same period were selected as the healthy control group.The levels of serum Endocan and ISM1 were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum Endocan,ISM1 and clinical indicators.Logistic regression model and re-ceiver operating characteristic curve were used to analyze the evaluation value of serum Endocan and ISM1 on adverse pregnancy outcomes in GDM patients.Results Compared with the healthy control group,the serum Endocan,fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS)and homeostasis model insulin resistance index(HOMA-IR)in the GDM group increased,and the serum ISM1 decreased(t/P=21.588/＜0.001,12.762/＜0.001,13.945/＜0.001,12.337/＜0.001,14.308/＜0.001,20.599/＜0.001);FPG,HbA1c,FINS and HOMA-IR were positively correlated with serum En-docan and negatively correlated with serum ISM1 in GDM group(r/P=0.632/＜0.001,0.701/＜0.001,0.698/＜0.001,0.727/＜0.001;-0.709/＜0.001,-0.607/＜0.001,-0.626/＜0.001,-0.745/＜0.001);Compared with the good prognosis subgroup,the poor prognosis subgroup had higher serum Endocan,HOMA-IR and lower serum ISM1(t/P=8.025/＜0.001,7.988/＜0.001,13.643/＜0.001);High serum Endocan and HOMA-IR were risk factors for adverse pregnancy outcomes of GDM,and high ISM1 was a protective factor[OR(95％CI)=1.556(1.230-1.968),1.354(1.102-1.663),0.681(0.543-0.855)];The AUC of En-docan,ISM1 and the combination of the two in predicting adverse pregnancy outcomes of GDM were 0.808,0.821 and 0.890,respectively,and the combination of the two was better than the individual prediction efficiency(Z=4.515,4.226,all P＜0.001).Conclusion The increase of serum Endocan and the decrease of serum ISM1 in GDM pregnant women are related to the body's glucose metabolism index The combination of the two has a high evaluation value for the prognosis of preg-nancy outcome in GDM patients.
Gestational diabetesEndothelial cell specific moleculesIsthmin 1Pregnancy outcome
维普
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