血清胎球蛋白A、胎球蛋白B在妊娠期糖尿病中的表达及其与妊娠结局的关系

The Expressions of Serum Fetuin A and Fetuin B in Gestational Diabetes Mellitus and Their Relationships with Pregnancy Outcome

目的探讨血清胎球蛋白A(Fetuin A)、胎球蛋白B(Fetuin B)在妊娠期糖尿病(GDM)中的表达及其与妊娠结局的关系。方法于2018年10月至2019年5月期间,选取在我院进行治疗的GDM患者82例作为GDM组,根据患者的妊娠结局将其分为不良妊娠组(32例)和正常妊娠组(50例)。另选取同期在我院进行产检的健康孕妇50例作为对照组。收集所有研究对象一般资料并检测血清Fetuin A、Fetuin B水平,另收集GDM组患者的收缩压、舒张压、总胆固醇、三酰甘油、空腹血糖(FBG)、糖化血红蛋白(HbA1c)等指标,分析GDM患者不良妊娠结局的危险因素,采用受试者操作特征曲线(ROC)分析血清Fetuin A、Fetuin B对GDM患者不良妊娠结局的预测价值。结果GDM组的孕前体质量指数、Fetuin A、Fetuin B均高于对照组,差异有统计学意义(P<0.05);不良妊娠组的年龄、FBG、HbA1c、Fetuin A、Fetuin B均高于正常妊娠组,差异有统计学意义(P<0.05);ROC曲线分析显示,血清Fetuin A、Fetuin B对GDM患者不良妊娠结局均有一定的预测价值,Fetuin A的曲线下面积为0.758,Fetuin B的曲线下面积为0.676,且二者联合检测可进一步提高预测价值;Logistic分析显示,年龄、FBG、HbA1c、Fetuin A、Fetuin B均是GDM患者不良妊娠结局的危险因素(P<0.05)。结论血清Fetuin A、Fetuin B在GDM中呈异常高表达,且二者均为GDM患者不良妊娠结局的危险因素,联合检测对患者的妊娠结局有一定的预测价值。

Objective To investigate the expressions of serum fetuin A and fetuin B in gestational diabetes mellitus(GDM)and their relationships with pregnancy outcome.Methods From October,2018 to June,2019,82 patients with GDM who were treated in our hospital were selected as the GDM group.According to the pregnancy outcome of the patients,they were divided into adverse pregnancy group and normal pregnancy group.Another 50 healthy pregnant women who underwent birth examination in our hospital during the same period were selected as the control group.The general data of all subjects were collected and the levels of serum fetuin A and fetuin B were measured.In addition,systolic blood pressure,diastolic blood pressure,total cholesterol,triacylglycerol,fasting blood glucose(FBG),HbA1c and other indexes were collected.The risk factors of adverse pregnancy outcome in patients with GDM were analyzed.The predictive value of serum fetuin A and fetuin B for adverse pregnancy outcome in patients with GDM was analyzed by receiver operating characteristic curve(ROC).Results The pre-pregnancy body mass index,fetuin A and fetuin B of the GDM group were significantly higher than those of the control group(P<0.05).The age,FBG,HbA1c,fetuin A and fetuin B of the adverse pregnancy group were significantly higher than those of the normal pregnancy group(P<0.05).ROC curve analysis showed that serum fetuin A and fetuin B had a certain predictive value for the adverse pregnancy outcome of patients with GDM.The area under the curve of fetuin A was 0.758,while the area under the curve of fetuin B was 0.676,and the combined detection of the two could further improve the predictive value.Logistic regression analysis showed that age,FBG,HbA1c,fetuin A and fetuin B were all risk factors of adverse pregnancy outcome in patients with GDM(P<0.05).Conclusion Serum fetuin A and fetuin B have abnormally high expressions in GDM,and both of them are risk factors of adverse pregnancy outcome in patients with GDM.Combined detection of these two markers has a certain predictive value for pregnancy outcome of patients with GDM.