妊娠期糖尿病胰岛自身抗体阳性与HLA-DRB_1基因型相关探析

Analysis of Correlation between the Diabetes Islet Antoantibody Positive in the Gestation Period and HLA-DRB_1 Genotype

目的探讨妊娠期糖尿病胰岛自身抗体阳性与HLA-DRB_1的关系。方法选取2013年6月—2016年6月期间在该院进行产检的孕妇作为研究对象,共有102例。将其分为对照组与观察组。对照组为非自身免疫性GDM孕妇,有61例。观察组为自身免疫性,抗体阳性,共有41例。比较两组GDM孕妇的妊娠结局和产后6周血糖情况。结果与对照组孕前相比,观察组孕妇的BMI较低,妊娠失风险系数高。两组GDM的HLA-DRB_1基因频率相比,差异无统计学意义。与正常人群相比,两组的HLA-DRB_1×04频率更高。差异有统计学意义(P<0.05)。最后,自身抗体显示阳性的,妊娠难度高。两组在胰岛素使用频率上,差异无统计学意义(P>0.05)。对比产后血糖的恢复情况,差异无统计学意义。结论 GDM属于多基因疾病,在遗传上有异质性,受到生活习惯、环境等因素的影响。同时,也还受到转归差异的影响。所以,必须加强随访、后期跟踪,认真研究此类妇女的远期预后,以便进行早期干预,延缓发病时间。

Objective To study the correlation between the diabetes Islet antoantibody positive in the gestation period and HLA-DRB1 genotype. Methods 102 cases of pregnant women with antenatal care in our hospital from June 2013 to June2016 were selected as the research objects and divided into two groups, the control group（61 cases） were the non-autoimmune GDM delivery women with 61 cases, while the observation group were the antoantibody positive delivery women with 41 cases, and the pregnant outcome of GDM delivery women and blood sugar after postpartum 6 weeks were compared between the two groups. Results The BMI in the observation group was lower than that in the control group, and the pregnant risk factor was higher in the observation group, and the difference in the HLA-DRB1 gene frequency between the two groups was not obvious, and the HLA-DRB1×04 frequency of the two groups was higher than that of the normal population,and the difference was obvious with statistical significance（P〈0.05）, finally, the antoantibody was positive and the pregnant difficulty is high, and there was no obvious difference in the use frequency of insulin without statistical significance（P〈0.05）,and the difference in the recovery of Postpartum blood glucose had no statistical significance by comparison. Conclusion GDM belongs to the multigenic disease with heterogenicity genetically, affected by the living habits, environment and outcome difference, therefore, we must enhance the following and late tracking carefully research the long-term prognosis of these women in order to carry out the early intervention and prolong the onset time.