血清Metrnl、Perilipin5预测妊娠期糖尿病孕妇不良妊娠结局价值

Predictive value of serum Metrnl and Perilipin 5 of pregnant women with gestational diabetes mellitus for their adverse pregnancy outcomes

目的:探讨妊娠期糖尿病(GDM)孕妇血清镍纹样蛋白(Metrnl)、脂滴包被蛋白5(Perilipin5)水平及预测不良妊娠结局价值。方法:选取2020年9月-2021年8月本院收治的GDM孕妇107例作为观察组,产前检查健康孕妇50例为对照组。酶联免疫吸附法检测血清Metrnl、Perilipin5水平,受试者工作特性曲线(ROC)评估血清Metrnl、Perilipin5对GDM孕妇不良妊娠结局的预测价值,采用多因素logistic回归分析探讨影响GDM孕妇发生不良妊娠结局的危险因素。结果:观察组血清Metrnl(125.17±13.54 pg/ml)、Perilipin5(316.47±79.64 pg/ml)水平低于对照组(164.82±22.65 pg/ml、762.53±145.25 pg/ml),且观察组中不良妊娠结局孕妇血清Metrnl、Perilipin5水平低于良好妊娠结局孕妇(均P<0.05)。观察组与对照组流产史、低密度脂蛋白、总胆固醇、甘油三酯、空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数均有差异(P<0.05)。ROC分析,Metrnl、Perilipin5预测GDM孕妇不良妊娠结局的曲线下面积(AUC)分别为0.846、0.813,截断值分别为119.53pg/ml、337.84pg/ml,特异度分别为67.5%、53.6%,敏感度分别为93.1%、93.1%,两者联合预测的AUC为0.936,特异度为85.0%,敏感度为86.2%。logistic回归分析,糖化血红蛋白≥6%、HOMA-IR≥2.69、Metrnl≤119.53pg/ml、Perilipin5≤337.84pg/ml是GDM孕妇发生不良妊娠结局的危险因素(P<0.05)。结论:GDM孕妇血清Metrnl、Perilipin5低表达,且能作为预测不良妊娠结局的生物学指标。

Objective:To explore the levels of serum Metrnl and Perilipin 5 of pregnant women with gestational diabe-tes mellitus(GDM),and to study the predictive value of the levels of serum Metrnl and Perilipin 5 for the adverse pregnancy outcomes of these women.Methods:107 pregnant women with GDM were selected in observation group and 50 healthy pregnant women who came to hospital for antenatal examination were selected in control group from Sep-tember 2020 to August 2021.The levels of serum Metrnl and Perilipin 5 of the women in the two groups were detected by enzyme linked immunosorbent assay.The predictive value of the levels of serum Metrnl and Perilipin 5 of the women with GDM for their adverse pregnancy outcomes was evaluated by receiver operator characteristic(ROC)curve.The risk factors of the adverse pregnancy outcomes of the women with GDM were explored by multivariate logistic re-gression analysis.Results:The levels of serum Metrnl(125.17±13.54 pg/ml)and Perilipin 5(316.47±79.64 pg/ml)of the women in the observation group were significantly lower than those(164.82±22.65 pg/ml and 762.53±145.25 pg/ml)of the women in the control group.In the observation group,the levels of Metrnl and Perilipin 5 of the women with adverse pregnancy outcomes were significantly lower than those of the women with normal pregnancy outcomes(P<0.05).There were significant differences in the abortion history,the levels of low density lipoprotein,total cho-lesterol,triglyceride,fasting blood glucose,fasting insulin,and glycosylated hemoglobin,and the insulin resistance index value of the women between the two groups(P<0.05).ROC curve analysis showed that the area under curve(AUC)of the Metrnl level and the Perilipin 5 level of the women with GDM for predicting their adverse pregnancy out-comes were 0.846 and 0.813,the cut-off values of which were 119.53pg/ml and 337.84pg/ml,the specificity of which were 67.5%and 53.6%,and the sensitivity of which were 93.1%and 93.1%.The AUC,the speeificity,and the sensi-tivity of the combined levels Metrnl and Perilipin 5 of the women with GDM for predicting their adverse pregnaney out-comes were 0.936,85.0%,and 86.2%,respectively.Logistic regression analysis showed that the glycosylated hemo-globin level≥6%,the HOMA-IR value≥2.69,the Metrnl level≤119.53 pg/ml,and the Perilipin 5 level≤337.84 pg/ml of the pregnant women with GDM were the risk factors of their adverse pregnancy outcomes(P<0.05).Conclu-sion:The levels Metrnl and Perilipin 5 of the women with GDM are lowly expressed,and which can be used as the bio-logical indicators for predicting the adverse pregnancy outcomes of the women.