血清谷胱甘肽过氧化物酶活性与妊娠期糖尿病的相关性研究

Correlation study between serum glutathione peroxidase activity and gestational diabetes mellitus

目的探讨血清谷胱甘肽过氧化物酶(GSH-PX)活性与妊娠期糖尿病(GDM)的相关性。方法回顾性分析2017年1~12月我院收治的50例GDM患者(GDM组)的临床资料与实验室检查数据,并于同期随机选取50例健康妊娠孕妇(正常组)作为对照,所有孕妇均在孕24~28+6周行口服葡萄糖耐量试验(OGTT)及血清GSH-PX活性检测。比较分析GDM孕妇血糖水平与血清GSH-PX活性的相关性及其对GDM的诊断价值。结果 GDM组孕妇的年龄、孕龄、糖尿病及高血压家族史情况与正常组比较,差异均无统计学意义(P>0.05)。GDM组孕妇的体质量指数(BMI)、空腹血糖(FBG)、餐后1 h血糖值(1 h PBG)、餐后2 h血糖值(2 h PBG)、空腹胰岛素(FINS)和HOMA模型胰岛素抵抗指数(HOMA-IR)均高于正常组(P<0.05),而HOMA胰岛β细胞功能(HOMA-β)及血清GSH-PX活性均低于正常组(P<0.05)。血清GSH-PX活性与妊娠中期FBG、1 h PBG、2 h PBG、HOMA-IR成负相关,与HOMA-β成正相关(P<0.05)。ROC分析显示血清GSH-PX活性预测GDM发生的灵敏度为0.787,特异度为0.843,ROC曲线下面积(AUC)为0.862,预测临界值为69.73 U/L。结论血清GSH-PX活性在妊娠期糖尿病孕妇血清中显著降低,可作为GDM预测诊断指标之一,其可能的机制为抗氧化能力降低所致的氧化损伤影响胰岛β细胞的功能而增加胰岛素抵抗。

Objective To investigate the correlation between serum glutathione peroxidase（GSH-PX） activity and gestational diabetes mellitus（GDM）. Methods The clinical data and laboratory findings of 50 patients with GDM（the GDM group）in our hospital from January to December in 2017 were retrospectively analyzed. Meanwhile, 50 healthy pregnant women（the normal group） were randomly selected as controls at the same time. All pregnant women were performed with oral glucose tolerance test（OGTT） and serum GSH-PX activity at 24-28＋6 weeks of gestation. The correlation between blood glucose levels in GDM pregnant women and serum GSH-PX activity and its diagnostic value for GDM were compared and analyzed. Results There were no significant differences in the age, gestational age, family history of diabetes mellitus and hypertension between the GDM group and the normal group（P〉0.05）. The Body mass index（BMI）, fasting blood glucose（FBG）, 1-hour postprandial blood glucose（1 h PBG）, 2-hour postprandial blood glucose（2 h PBG）, fasting insulin（FINS） and HOMA model insulin resistance index（ HOMA-IR） in the GDM group were all higher than those of the normal group（P〈0.05）, while HOMA islet β-cell function（HOMA-β） and serum GSH-PX activity in the GDM group were lower than those in the normal group（P〈0.05）. Serum GSH-PX activity was negatively correlated with FBG, 1 h PBG, 2 h PBG, HOMA-IR, but positively correlated with HOMA-β（P〈0.05）. ROC analysis showed that the sensitivity and specificity of serum GSH-PX activity to predict GDM were 0.787 and 0.843 respectively. The area under the ROC curve（AUC） was 0.862, and the predicted threshold was 69.73 U/L. Conclusion Serum GSH-PX activity significantly decreases in the serum of pregnant women with GDM and can be considered as one of the predictive indicators of GDM. The possible mechanism is that oxidative damage due to decreased antioxidant capacity affects the function of islet β cells and increases insulin resistance.