孕早期孕妇促甲状腺激素、甲状腺过氧化物酶抗体及微小RNA-873-5p水平与妊娠期糖尿病相关性研究

Correlation between TSH,TPOAb,miR-873-5p levels in early pregnancy and gestational diabetes mellitus

目的:分析研究孕早期促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)及微小RNA-873-5p(miR-873-5p)水平与妊娠期糖尿病(GDM)的相关性。方法:选取定期产检的GDM孕妇命名为GDM组(n=109),另选同期在本院产检的糖耐量正常孕妇为对照组(n=60)。收集两组孕妇的一般资料及孕早期实验室检测指标(TSH、TPOAb、miR-873-5p),采用单因素、多因素分析TSH、TPOAb、miR-873-5p水平与GDM的关系;并绘制ROC曲线分析血清TSH、TPOAb、miR-873-5p水平对GDM的预测价值。结果:GDM组的血清TSH、TPOAb、miR-873-5p水平均高于对照组,差异具有统计学意义(均P<0.05);多因素Logistic回归分析显示,年龄>30岁(OR=1.982)、孕前BMI≥24 kg/m^(2)(OR=2.020)、TSH升高(OR=2.113)、TPOAb升高(OR=2.307)及miR-873-5p水平升高(OR=2.059)是发生GDM的独立危险因素(均P<0.05);ROC曲线分析显示,血清TSH、TPOAb、miR-873-5p及联合检测的曲线下面积(AUC)分别为0.830、0.829、0.762、0.936,联合检测优于单一检测(P<0.05)。结论:TSH、TPOAb及miR-873-5p在GDM孕妇体内呈高表达,可能成为GDM发生的辅助预测指标。

Objective:To analyze the correlation between the levels of thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb),miR-873-5p in early pregnancy and gestational diabetes mellitus(GDM).Methods:Pregnant women with GDM who underwent regular antennalexaminations were selected as GDM group(n=109),and pregnant women with normal glucose tolerance who underwent antennalexaminations during the same period were selected as control group(n=60).The general data and early pregnancy laboratory detection indicators(TSH,TPOAb,miR-873-5p)of the two groups were collected,and the relationship between the levels of TSH,TPOAb,miR-873-5p and GDM was analyzed by univariate and multivariate analysis.ROC curve was drawn to analyze the predictive value of serum TSH,TPOAb and miR-873-5p levels on GDM.Results:The levels of serum TSH,TPOAb and miR-873-5p in GDM group were higher than those in control group,with statistical significance(P<0.05).Multivariate Logistic regression analysis showed that Age>30 years old(OR=1.982),pregnancy BMI≥24 kg/m^(2)(OR=2.020),elevated TSH(OR=2.113),elevated TPOAb(OR=2.307)and elevated miR-873-5p(OR=2.059)were independent risk factors for GDM(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum TSH,TPOAb,miR-873-5p and combined detection were 0.830,0.829,0.762,0.936,respectively,and combined detection was superior to single detection(P<0.05).Conclusion:TSH,TPOAb and miR-873-5p are highly expressed in pregnant women with GDM,which may be auxiliary predictors of the occurrence of GDM.