外周血Sfrp-5在妊娠期糖尿病患者中的表达及意义分析

Analysis of expression and significance of peripheral blood Sfrp-5 in patients with gestational diabetes mellitus

目的:探讨外周血分泌型卷曲相关蛋白-5(Sfrp-5)与妊娠期糖尿病(GDM)病情及预后的相关性.方法:回顾性分析96例GDM患者临床资料为病例组,另纳入30例产前检查健康孕妇临床资料为对照组.比较不同胰岛素抵抗、不同肾损伤、不同妊娠结局孕妇早期检测外周血Sfrp-5水平差异,采用Pearson相关系数模型分析上述指标与GDM患者胰岛素抵抗指数(HOMA-IR)、尿微量白蛋白排泄率(UAER)的相关性,通过受试者工作特征(ROC)曲线分析外周血Sfrp-5水平对GDM患者妊娠结局的早期预测效能.结果:不同胰岛素抵抗、不同肾损伤、不同妊娠结局孕妇外周血Sfrp-5水平均有统计学意义,且GDM患者HOMA-IR、UAER与外周血Sfrp-5水平呈显著负相关性.该指标预测GDM患者妊娠结局的截断值为9.31ng/L,预测敏感度、特异度分别为57.14%、90.67%.结论:外周血Sfrp-5与GDM患者胰岛素抵抗、肾损伤程度密切相关,临床早期检测可为孕期营养管理及肾脏保护提供指导,对改善妊娠结局有利.

Objective To explore the correlation between peripheral blood secretory fragile-related protein-5(Sfrp-5)and disease condition and prognosis of gestational diabetes mellitus(GDM).Methods The clinical data of 96 patients with GDM(case group)were retrospectively analyzed,and another 30 healthy pregnant women with antenatal check-up were selected as control group.The differences in early detection of peripheral blood Sfrp-5 level were compared among pregnant women with different insulin resistance,different renal injuries and different pregnancy outcomes,and Pearson correlation coefficient model was used to analyze the correlation between the above indicator and homeostasis model assessment of insulin resistance(HOMA-IR)and urinary albumin excretion rate(UAER)in patients with GDM.The early predictive efficiency of peripheral blood Sfrp-5 level on pregnancy outcomes in patients with GDM was analyzed by receiver operating characteristic(ROC)curve.Results There was a statistical significance in the level of Sfrp-5 in peripheral blood among pregnant women with different insulin resistance,renal injuries and pregnancy outcomes,and HOMA-IR and UAER in patients with GDM were significantly negatively correlated with peripheral blood Sfrp-5 level.The cut-off value of Sfrp-5 for predicting the pregnancy outcomes of patients with GDM was 9.31 ng/L,and the predictive sensitivity and specificity were 57.14%and 90.67%respectively.Conclusion Peripheral blood Sfrp-5 is closely related to insulin resistance and renal injury degree of patients with GDM.Early clinical detection can provide guid-ance for nutrition management and kidney protection during pregnancy and is beneficial to improving pregnancy outcomes.