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血清miR-26b、miR-320b水平与GDM胰岛素抵抗相关性

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目的:分析血清微小RNA-26b(miR-26b)、miR-320b水平与妊娠期糖尿病(GDM)患者发生胰岛素抵抗(IR)的相关性.方法:回顾性随机选取本院2020年5月-2023年5月收治的GDM孕妇85例纳入GDM组,同期产前检查健康孕妇90例为对照组.检测两组孕妇血清miR-26b、miR-320b水平,收集两组孕妇临床相关资料并进行比较.用Pearson法分析miR-26b、miR-320b水平与GDM孕妇IR的相关性.根据研究组孕妇是否发生IR将其分成有IR组和无IR组,单因素和多因素分析GDM孕妇发生IR的影响因素.结果:两组年龄、孕周、生产史、收缩压、舒张压比较无差异(P>0.05);GDM组孕前体质指数(BMI)高于对照组,miR-26b、miR-320b水平均低于对照组,胰岛素抵抗指数(HOMA-IR)高于对照组(均P<0.05).GDM组孕妇miR-26b、miR-320b水平与HOMA-IR水平呈负相关(P<0.05),孕妇IR发生率为61.7%.IR孕妇孕前BMI、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、空腹胰岛素(FINS)水平均高于无IR孕妇,miR-26b、miR-320b均低于无IR孕妇(均P<0.05).经logistic回归分析显示,miR-26b(OR=0.305)、miR-320b(OR=0.426)是GDM孕妇发生IR的独立保护因素(均P<0.05).ROC曲线分析显示,miR-26b、miR-320b及二者联合预测GDM孕妇发生IR的敏感度分别为73.9%、69.6%、87.0%,特异性分别为66.2%、71.6%、87.8%,曲线下面积分别为0.778、0.798、0.918.结论:miR-26b、miR-320b在GDM孕妇中异常低表达,且与HOMA-IR 呈负相关;miR-26b、miR-320b升高是GDM孕妇发生IR的保护因素,二者联合检测可有效预测GDM孕妇发生IR情况.
Correlation between the levels of serum microrNA 26b and microrNA 320b of pregnant women with gestational diabetes mellitus and their insulin resistance
Objective:To analyze the correlation between the levels of serum microrNA(miR)26b and miR 320b of pregnant women with gestational diabetes mellitus(GDM)and their insulin resistance(IR).Methods:A total of 85 pregnant women with GDM admitted to hospital from May 2020 to May 2023 were selected in study group retrospec-tively,and 90 healthy pregnant women who underwent prenatal examination were selected in control group during the same period.The levels of serum miR 26b and miR 320b of the women in the two groups were detected.The clinical data of the women were collected and were compared between the two groups.Pearson method was used to analyze the correlation between the miR 26b and miR 320b levels of the women with GDM and their IR.According to whether the women with IR or not,the women in the study group were divided into group A(women with IR)and group B(women without IR).The influencing factors of the IR occurrence of the women with GDM were analyzed by univari-ate and multivariate factors.Results:There were no significant differences in the age,the gestational weeks at deliver-y,the delivery history,and the values of systolic blood pressure and diastolic blood pressure of the women between the study group and the control group(P>0.05).The values of the pregnancy body mass index(BMI)and the homeostasis model assessment of insulin resistance(HOMA-IR)of the women in the study group were significantly higher than those of the women in the control group,and the levels of miR 26b and miR 320b of the women in the study group were significantly lower than those of the women in the control group(all P<0.05).The levels of miR 26b and miR 320b of the women in the study group were negatively correlated with their HOMA-IR value(P<0.05),with the IR incidence of 61.7%.The BMI value,and the levels of glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG)and fasting insulin(FINS)of the pregnant women with IR were significantly higher than those of the pregnant women without IR,and the levels of miR 26b and miR 320b of the pregnant women with IR were significant-ly lower(all P<0.05).Logistic regression analysis showed that the miR 26b level(OR=0.305)and the miR 320b lev-el(OR=0.426)of the women with GDM were the independent protection factor of their IR occurrence(all P<0.05).ROC curve analysis showed that the sensitivity of the miR 26b level,the miR 320b level,and the combined miR 26b and miR 320b levels of the women with GDM for predicting their IR occurrence were 73.9%,69.6%and 87.0%,re-spectively,the specificity of which were 66.2%,71.6%and 87.8%,respectively,and the area under the curve of which were 0.778,0.798 and 0.918,respectively.Conclusion:The expressions of miR 26b and miR 320b of the preg-nant women with GDM are abnormally low,and which are negatively correlated with their HOMA-IR value.The in-creases of the miR 26b and miR 320b levels of the pregnant women with GDM are the protective factors of their IR oc-currence.The combined detection of the miR 26b and miR 320b levels of the pregnant women with GDM can effectively predict their IR occurrence.

Gestational diabetes mellitusInsulin resistance indexMicrorNA 26bMicrorNA 320bInfluencePre-diction

高茜、曹滋菁、张铭

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江苏省常州市妇幼保健院(213000)

妊娠期糖尿病 胰岛素抵抗指数 微小RNA-26b 微小RNA-320b 影响 预测

江苏省妇幼健康科研项目

F202125

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(2)
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