GDM母体血清HIF-1α、ET-1、尿酸、内脂素的变化与新生儿Apgar评分、体质量的关系

Relationship between the changes of serum HIF-1α,ET-1,uric acid and visfatin levels in pregnant women with gestational diabetes mellitus and neonatal Apgar score and birth weight

目的 探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)母体血清中缺氧诱导因子1α(hypoxia-inducible factor alpha,HIF-1α)、内皮素-1(endothelin-1,ET-1)、尿酸、内脂素水平的变化及与新生儿Apgar评分、体质量情况的关系。 方法 选取150例GDM孕妇(GDM组)、正常妊娠妇女150例(对照组),收集时间2016年1月-2017年6月,检测并比较两组孕24~28周的血清HIF-1α、ET-1、尿酸、内脂素水平,并随访至分娩结束,观察两组新生儿的分娩结局,探讨上述指标与新生儿结局的关系。 结果 孕24~28周,GDM组的HIF-1α、ET-1、尿酸、内脂素水平显著高于对照组,差异有统计学意义(P<0.05);GDM组和对照组的分娩方式、胎膜早破发生率差异无统计学意义(P>0.05);GDM组的分娩孕周、1 min Apgar评分均显著低于对照组(P<0.05),GDM组新生儿的体质量大于对照组(P<0.05);GDM组孕妇血清HIF-1α、ET-1水平与新生儿的1 min Apgar评分呈显著的负相关关系(P<0.05),GDM组孕妇血清尿酸、内脂素水平与新生儿的体质量呈显著的正相关关系(P<0.05)。 结论 GDM孕妇的HIF-1α、ET-1、尿酸、内脂素水平均升高,并且与新生儿Apgar评分、体质量密切相关。

Objective To explore the changes of serum hypoxia-inducible factor alpha (HIF-1α), endothelin-1(ET-1), uric acid and visfatin levels in pregnant women with gestational diabetes mellitus (GDM) and their correlation with neonatal Apgar score and body weight. Methods One hundred and fifty GDM pregnant women (the GDM group) and 150 normal pregnant women (the control group) were selected from January 2016 to June 2017. The maternal serum levels of HIF-1α, ET-1, uric acid and alfatin at the 24-28 weeks of gestation were detectedand compared between the two groups. All pregnant women were followed up until the end of pregnancy. The neonatal outcomes of the two groups were observed, and the relationship between the above-mentioned indexes and neonatal outcomes was explored. Results The maternal serum levels of HIF-1α, ET-1, uric acid and alfatin at 24-28 weeks of gestation were significantly higher in the GDM group than in the control group, showing statistically significant differences (all P<0.05). No statistically significant differences were observed in the mode of delivery and the incidence rate of premature rupture of membranes between the two groups (both P>0.05). Pregnancy weeks and the 1-min Apgar score were significantly lower in the GDM group than in the control group (both P<0.05), while neonatal birth weight was higher in the GDM group than in the control group (P<0.05). The maternal serum levels of HIF-1α and ET-1 in the GDM group were negatively correlated with the 1-min Apgar score (P<0.05), whereas the maternal serum levels of uric acid and visfatin in the GDM group were positively correlated with neonatal birth weight (P<0.05). Conclusions Serum HIF-1α, ET-1, uric acid and visfatin levels of the GDM pregnant women are all increased; moreover, they are closely related to neonatal Apgar score and birth weight.