血清Chemerin、25(OH)D3、visfatin水平检测对妊娠期糖尿病的诊断价值及与患者胰岛素抵抗的关联性

The diagnostic value of serum chemerin,25(OH)D3,visfatin levels in gestational diabetes mellitus and their association with insulin resistance

目的探讨血清趋化素(Chemerin)、25 羟基维生素D3[25(OH)D3]、内脂素(visfatin)水平检测对妊娠期糖尿病(GDM)的诊断价值及与患者胰岛素抵抗(IR)的关联性。方法选取2017年2月至2019年3月本院GDM患者80例设为研究组,另选取同期正常体检妊娠女性80例设为对照组。入院后抽2组血液样本,测定对比研究组、对照组血清Chemerin、25(OH)D3、visfatin水平、稳态模型胰岛素抵抗指数(HOMA IR),并统计分析血清Chemerin、25(OH)D3、visfatin水平与HOMA IR关联性、Chemerin、25(OH)D3、visfatin单独与联合应用对GDM的诊断效能。结果研究组血清25(OH)D3水平为(27.26±5.11)nmol/L,低于对照组(38.71±8.63)nmol/L,血清Chemerin、visfatin水平分别为(273.92±40.20)ng/mL、(23.54±2.66)ng/mL,高于对照组(186.14±26.06)ng/mL、(11.68±1.80)ng/mL(t1=10.211、t2=16.388、t3=33.028,P均<0.001);研究组HOMA IR为(3.89±1.38)高于对照组(1.62±0.46)(t=13.958,P<0.001);经Spearman相关分析,血清25(OH)D3水平与HOMA IR呈显著负相关,血清Chemerin、visfatin水平与HOMA IR呈显著正相关(r1=-0.576、r2=0.604、r3=0.792,P均<0.001);Chemerin、25(OH)D3、visfa tin联合诊断GDM的敏感度95.00%高于单一指标诊断(c2=14.546,P=0.002)。结论血清Chemerin、25(OH)D3、visfatin水平与GDM患者胰岛素抵抗密切相关,在疾病发生、进展中具有重要作用,3者联合检测可提升GDM诊断敏感度,为临床诊断提供一定依据。

Objective To investigate the diagnostic value of serum chemoattractant(Chemerin),25 hydroxyvitamin D3[25(OH)D3]and visfatin levels in gestational diabetes mellitus(GDM)and insulin resistance in patients(IR)relevance.Methods 80 patients with GDM in our hospital from February 2017 to March 2019 were enrolled,and 80 women with normal physical examination during the same period were recruited as the control group.Two groups of blood samples were collected after admission,and serum Chemerin,25(OH)D3,visfatin levels,steady state model insulin resistance index(HOMA IR)were measured.The correlation between the levels of serum Chemerin,25(OH)D3,visfatin and HOMA IR was statistically analyzed.The diagnostic efficacy of Chemerin,25(OH)D3,visfatin alone and in combination was evaluated.Results The level of serum 25(OH)D3 in the study group was(27.26±5.11)nmol/L,lower than that in the control group(38.71±8.63)nmol/L,and the levels of serum Chemerin and visfatin were(273.92±40.20)ng/mL,(23.54±2.66)ng/mL,higher than that in the control group(186.14±26.06)ng/mL,(11.68±1.80)ng/mL(t1=10.211,t2=16.388,t3=33.028,respectively,P<0.001).The HOMA IR of the study group was(3.89±1.38)higher than that of the control group(1.62±0.46)(t=13.958,P<0.001).By Spearman correlation analysis,the serum 25(OH)D3 level was negatively correlated with HOMA IR,the serum Chemerin and visfatin levels were positively correlated with HOMA IR(r1=-0.576,r2=0.604,r3=0.792,P<0.001).The sensitivity of chemorin,25(OH)D3 and visfatin in the diagnosis of GDM was 95.00%higher than that of single index(c2=14.546,P=0.002).Conclusion The levels of serum Chemerin,25(OH)D3 and visfatin are closely related to insulin resistance in GDM patients,and play an important role in the occurrence and progression of the disease.The combined detection of three can improve the diagnostic sensitivity of GDM.