Relationship between Serum Ferritin,NF-κB and Insulin Resistance and Adverse Pregnancy Outcomes in Pregnant Women with GDM
To investigate the relationship between serum ferritin(SF),nuclear factor-KB(NF-κB)and insulin resistance(IR)and adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus(GDM),a total of 115 pregnant women with GDM treated in the authors'hospital from May 2020 to February 2023 were selected as the observation group,and 115 pregnant women with normal glucose tolerance during the same period were selected as the control group.Serum SF,NF-κB levels,blood glucose[fasting blood glucose(FPG),2h post-meal blood glucose(2h PG)]and IR biochemical indices[fasting insulin(FINS),insulin secretion index(IS),insulin resistance index(HOMR-IR)]were detected and compared between the two groups.IR levels were divided according to HOMR-IR.The levels of serum SF and NF-κB in different IR levels were compared.Pregnancy outcomes of the two groups were followed up and recorded.Serum SF and NF-κB levels were compared in pregnant women with different pregnancy out-comes of GDM,and the correlation between serum SF and NF-κB levels and the degree of IR and pregnancy outcomes was analyzed,and the predictive value of combined detection of SF and NF-κB in adverse pregnancy outcomes of pregnant women with GDM was analyzed.The levels of serum SF and NF-κB in observation group were higher than those in control group[(49.31±12.53)μg/L,(14.86±4.71)ng/mL vs(24.63±9.63)μg/L,(8.63±2.73)ng/mL;P＜0.05].FPG,2h PG,FINS and HOMR-IR in observa-tion group were higher than those in control group.IS was lower than control group[(4.97±0.61)mmol/L,(9.79±0.83)mmol/L,(10.57±2.68)μU/mL,(2.13±0.46)％,(2.33±0.86)％vs(4.23±0.68)mmol/L,(8.01±0.62)mmol/L,(9.73± 3.17)μU/mL,(2.30±0.57)％,(1.83±0.74)％;P＜0.05];There is a statistically significant difference in the incidence of adverse pregnancy outcomes between the two groups(42.61％vs 18.26％)(x2=16.100,P＜0.001);Comparison of serum SF and NF-κB levels in pregnant women with different IR levels in GDM:HOMR-IR(0～1)＜HOMR-IR(1～2)＜HOMR-IR(2～3)＜(HOMR-IR＞3)[(26.89±9.75)＜(42.82±10.06)＜(51.16±10.25)＜(62.17±11.47)μg/L;(8.94±2.65)＜(12.71± 4.11)＜(15.01±4.53)＜(19.74±4.60)ng/mL;P＜0.05];The levels of serum SF and NF-κB in GDM women with adverse pregnancy outcomes were higher than those in women with good pregnancy outcomes[(74.62±10.59)μg/L,(19.16±4.57)ng/mL vs(30.52±10.84)μg/L,(9.07±2.95)ng/mL;P＜0.05];Serum SF and NF-κB levels were positively correlated with IR(r=0.746,0.612)and pregnancy outcome(r=0.811,0.793)in pregnant women with GDM(P＜0.05).The AUC of the combined prediction of SF and NF-κB for adverse pregnancy outcomes in GDM pregnant women was 0.913,which was higher than that of SF and NF-κB alone(P＜0.05).Abnormal expression of SF and NF-κB in serum of pregnant women with GDM is closely related to IR level and adverse pregnancy outcome.Combined detection of SF and NF-κB is beneficial to predict adverse pregnancy outcome of pregnant women with GDM.
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