孕早期性激素结合球蛋白与妊娠期糖尿病的相关性

Correlation between first trimester sex hormone binding globulin and subsequent gestational diabetes mellitus

目的:观察孕早期性激素结合球蛋白(SHBG)水平与妊娠期糖尿病(GDM)的关系。方法:孕期行糖筛查和糖耐量试验确诊的41例GDM患者作为试验记录组,以未发生GDM的734例妊娠期孕妇作为对照组,检测并比较两组中SHBG、睾酮(T)、雌二醇(E2)等表达水平,采用Logistic回归分析进行GDM危险因素的分析。结果:①妊娠前3个月GDM组SHBG水平[(269.55±119.35)nmol.L-1]明显低于对照组[(321.77±124.21)nmol.L-1],差异具有显著性(P<0.05)。②Logistic回归分析显示,SHBG与GDM之间存在独立相关性(β=0.622,P=0.025,OR=1.864,95%CI:1.083～3.207)。③随SHBG水平的下降,GDM的发病率逐渐升高。结论:孕早期低水平SHBG是发生GDM的独立危险因素,SHBG可能成为孕早期预测GDM的一项指标。

Objective To explore the association between sex hormone binding globulin （SHBG） in first trimester of pregnancy and subsequent development of gestational diabetes mellitus （GDM） . Methods During pregnancy, 41 patients with GDM diagnosed with glucose screening and glucose tolerance test were used as GDM group, 734 cases of pregnant women without GDM were used as control group, and the expression levels of SHBG, T, E2 in two groups were compared. Logistic regression analysis was adopted to analyse the risk factors for GDM. Results ①The level of SHBG in GDM group （269.55 nmol · L^-1 ± 119.35 nmol · L^-1 ） in first trimester of pregnancy was lower than that in control group （321.77 nmol · L^-1 ±124. 21 nmol · L^-1 ） （P〈0. 05）. ②Logistic regression analysis result showed there was independent association between SHBG level and GDM （β=0. 622, P= 0.025, OR= 1. 864, 95% CI 1. 083- 3. 207）. ③With the decrease of SHBG level , the morbidity of GDM increased. Conclusion First-trimester SHBG level has independent association with subsequent GDM , SHBG offers a potential early marker to target women who are at risk for GDM.