文章摘要
血清Ferritin、Cat S、MCP-1与妊娠期糖尿病患者胰岛素抵抗的关系及妊娠结局的影响因素分析
Relationship between serum Ferritin, Cat S, MCP-1 and insulin resistance in patients with gestational diabetes mellitus and influencing factors analysis of pregnancy outcome
投稿时间:2022-06-09  修订日期:2022-06-09
DOI:
中文关键词: 铁蛋白  组织蛋白酶S  单核细胞趋化蛋白-1  妊娠期糖尿病  胰岛素抵抗  妊娠结局  影响因素
英文关键词: Ferritin  Cathepsin S  Monocyte chemotactic protein-1  Gestational diabetes mellitus  Insulin resistance  Pregnancy outcome  Influence factor
基金项目:河北省卫生健康委青年科技课题(20190294)
作者单位邮编
邢慧敏 石家庄市妇幼保健院 050000
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中文摘要:
      目的:探讨血清铁蛋白(Ferritin)、组织蛋白酶S(Cat S)、单核细胞趋化蛋白-1(MCP-1)与妊娠期糖尿病(GDM)患者胰岛素抵抗的关系,并分析影响GDM患者妊娠结局的影响因素。方法:选取2019年4月~2021年12月期间来石家庄市妇幼保健院产检并诊断为GDM的产妇154例纳为GDM组,另取同期来石家庄市妇幼保健院产检的健康产妇100例作为对照组。检测对比两组的血清Ferritin、Cat?S、MCP-1水平以及稳态模型胰岛素抵抗指数(HOMA-IR),血清Cat?S、Ferritin、MCP-1与HOMA-IR的相关性以Pearson相关系数进行分析。GDM组患者根据妊娠结局分为正常妊娠结局组和不良妊娠结局组,妊娠结局的影响因素采用多因素Logistic回归分析。结果:GDM组血清Ferritin、Cat?S、MCP-1水平及HOMA-IR均高于对照组(P<0.05)。Pearson相关性分析结果显示,GDM患者的血清Cat?S、Ferritin、MCP-1水平与HOMA-IR均呈正相关(P<0.05)。154例GDM患者中,有58例出现不良妊娠结局,占比37.66%。单因素分析结果显示,GDM患者的妊娠结局与糖尿病家族史、GDM确诊时孕周、年龄、口服葡萄糖耐量试验(OGTT)结果、孕前体质量指数(BMI)、血清Ferritin、Cat?S、MCP-1水平以及HOMA-IR有关(P<0.05)。多因素Logistic回归分析结果显示:年龄≥35岁、孕前BMI≥24kg/m2、OGTT结果>2项异常、血清Ferritin、Cat?S、MCP-1水平偏高是GDM患者妊娠结局不良的危险因素(P<0.05)。结论:GDM患者的血清Ferritin、Cat S、MCP-1水平异常升高,且与胰岛素抵抗有关。GDM患者的妊娠结局受到血清Ferritin、Cat?S、MCP-1水平、年龄、孕前BMI、OGTT结果等因素影响。
英文摘要:
      Objective: To investigate the relationship between serum Ferritin, cathepsin S (Cat S), monocyte chemotactic protein-1 (MCP-1) and insulin resistance in patients with gestational diabetes mellitus (GDM), and to analyze the influencing factors of pregnancy outcome in patients with GDM. Methods: A total of 154 parturients diagnosed with GDM in Shijiazhuang Maternal and Child Health Hospital from April 2019 to December 2021 were included as the GDM group, another 100 healthy parturients who came to Shijiazhuang Maternal and Child Health Hospital during the same period were taken as the control group. Serum Ferritin, Cat S, MCP-1 levels and homeostasis model insulin resistance index (HOMA-IR) were detected and compared between the two groups, and the correlation between serum Cat S, Ferritin, MCP-1 and HOMA-IR was analyzed by Pearson correlation coefficient. The GDM group was divided into normal pregnancy outcome group and poor pregnancy outcome group according to pregnancy outcome, and the influencing factors of pregnancy outcome were analyzed by multiple Logistic regression. Results: The serum Ferritin, Cat S, MCP-1 levels and HOMA-IR in GDM group were higher than those in control group (P<0.05). Pearson correlation analysis showed that serum Cat S, Ferritin and MCP-1 levels were positively correlated with HOMA-IR in patients with GDM (P<0.05). Among 154 patients with GDM, 58 cases had adverse pregnancy outcomes, accounting for 37.66%. Univariate analysis showed that pregnancy outcome of patients with GDM was related to diabetes family history, gestational age at diagnosis of GDM, age, oral glucose tolerance test (OGTT) results, pre-pregnancy body mass index (BMI), serum Ferritin, Cat S, MCP-1 levels and HOMA-IR (P<0.05). Multivariate Logistic regression analysis showed that age ≥35 years, pre-pregnancy BMI≥24kg/m2, OGTT results > 2 items abnormal, and serum Ferritin, Cat S and MCP-1 high levels were risk factors for poor pregnancy outcome in patients with GDM (P<0.05). Conclusion: The serum Ferritin, Cat S and MCP-1 levels in patients with GDM are abnormally elevated, which are related to insulin resistance. Pregnancy outcomes of patients with GDM are affected by Ferritin, Cat S, MCP-1 levels, age, pre-pregnancy BMI, OGTT results and other factors.
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