妊娠期糖尿病孕早期血清Betatrophin、IL-33、ADP表达与糖脂代谢

The expression of serum Betatrophin, IL-33, ADP of pregnant women during the early stage of gestational diabetes mellitus, and their relationship with glycolipid metabolism

目的:探讨妊娠期糖尿病(GDM)患者早期血清促代谢因子(Betatrophin)、白介素-33(IL-33)及脂联素(ADP)表达及与糖脂代谢关系。方法:选取GDM患者43例(GDM组)、糖耐量正常孕妇51例(NGT组)、健康未孕妇女40例(对照组)为研究对象,检测各组血清Betatrophin、IL-33、ADP水平和糖脂代谢指标,并Pearson分析与胰岛素抵抗、糖代谢指标的关系,ROC分析对GDM发生的预测价值。结果:GDM组孕期体重增加、新生儿出生体重大于NGT组(P<0.05);血清Betatrophin、IL-33、FPG、FINS、HOMA-IR、TG、LDL-C水平GDM组>NGT组>对照组,血清ADP、HDL-C水平GDM组<NGT组<对照组(均P<0.05)。血清Betatrophin与TG、孕期体重增加、新生儿出生体重呈正相关,IL-33与HOMA-IR、TG呈正相关,ADP与FPG、FINS、HOMA-IR呈负相关(均P<0.05)。Betatrophin、IL-33、ADP诊断GDM曲线下面积(AUC)分别为0.830、0.655、0.719,灵敏度分别为86.3%、72.2%、75.0%,特异度分别为82.1%、79.1%、80.3%。结论:GDM患者早期血清Betatrophin、IL-33水平升高,ADP水平降低,Betatrophin、IL-33、ADP水平变化与GDM发病有关,孕早期监测其水平可为预防GDM发生提供参考依据。

Objective: To investigate the expression of Betatrophin, interleukin-33 (IL-33) and adiponectin (ADP) of pregnant women during the early stage of gestational diabetes mellitus (GDM), and to explore their relationship with glycolipid metabolism. Methods: In this study, there were 43 patients with GDM in GDM group, 51 pregnant women with normal glucose tolerance in NGT group, and 40 healthy non-pregnant women in the control group. Serum levels of Betatrophin, IL-33 and ADP, and glycolipid metabolic indexes of all included women were detected. Pearson analysis was used to analyze the relationship of the levels of Betatrophin, IL-33 and ADP with indexes of insulin resistance and glycometabolism. ROC analysis was used to analyze the value of levels of Betatrophin, IL-33 and ADP for predicting GDM. Results: The gestational weight gain of women and neonatal birth weight in GDM group were significant higher than those in NGT group ( P <0.05). The serum levels of Betatrophin, IL-33, FPG, FINS, HOMA-IR, TG and LDL-C of women in GDM group were highest, but those of women in the control group were lowest ( P <0.05). The serum levels of ADP and HDL-C of women in GDM group were lowest, but those of women in the control group were highest ( P <0.05).The serum Betatrophin level was positively correlated with TG level, value of gestational weight gain, and neonatal birth weight ( r=0.425-0.621, P <0.05), the serum IL-33 level was positively correlated with HOMA-IR value and TG level( r=0.392, 0.295, P <0.05), and ADP level was negatively correlated with levels of FPG and FINS and HOMA-IR value ( r=-0.316-0.620, P <0.05). The area under the curve (AUC), the sensitivity, and the specificity of Betatrophin level were 0.830, 86.3%, and 82.1%, respectively. The AUC, the sensitivity, and the specificity of IL-33 level were 0.655, 72.2%, and 79.1%, respectively. The AUC, the sensitivity, and the specificity of ADP level were 0.719, 75.0% and 80.3%, respectively. Conclusion: The serum levels of Betatrophin and IL-33 of women with GDM increase during the early stage of GDM, but ADP level decreases, which all are related to the occurrence of GDM. Monitoring the levels of Betatrophin, IL-33, and ADP of pregnant women during the early pregnancy maybe provide evidence for preventing the occurrence of GDM.