妊娠期糖尿病患者血清组织蛋白酶S与HOMA-IR的相关性

Correlation between serum Cathepsin S and HOMA-IR in patients with gestational diabetes mellitus

目的探讨妊娠期糖尿病患者血清中组织蛋白酶S(Cat S)的表达情况,并初步探讨血清Cat S表达与稳态胰岛素抵抗指数(HOMA-IR)的关系。方法选取产科择期行剖宫术的妊娠期糖尿病孕妇77例为妊娠期糖尿病组,选取同期择期剖宫术的糖耐量正常孕妇82例为对照组。采用全自动生化分析仪检测空腹血清葡萄糖(FPG)、空腹胰岛素(FIN)、总胆固醇(TC)、三酰甘油(TG)水平,按公式计算得HOMA-IR,通过酶联免疫吸附法检测受试者血清Cat S水平,通过Pearson法分析妊娠期糖尿病患者血清Cat S水平与HOMA-IR、TC、TG水平相关性,多元线性回归分析HOMA-IR影响因素,二元logistic回归分析妊娠期糖尿病的危险因素。结果与对照组相比,妊娠期糖尿病组入组时BMI(BMI2)、BMI2与孕前BMI(BMI1)差值(BMI3)、TG、FPG、FINS、HOMA-IR水平显著升高(P<0.05);与对照组相比,妊娠期糖尿病组患者血清Cat S水平显著升高(P<0.05);Pearson相关性显示,妊娠期糖尿病组患者血清Cat S水平与BMI3、TG、FINS、HOMA-IR水平均呈正相关(P<0.05);血清BMI3、FPG、FINS、Cat S是HOMA-IR的影响因素(P<0.05);血清BMI3升高、Cat S升高、HOMA-IR升高、TG升高均是妊娠期糖尿病发生的危险因素(OR=1.358、2.035、1.898、0.939,P<0.05)。结论妊娠期糖尿病患者血清Cat S水平升高,与HOMA-IR呈正相关,孕期监测血清Cat S水平意义重大。

Objective To investigate the expression of Cathepsin S(Cat S)in the serum of gestational diabetes mellitus(GDM),and the correlationbetween the expression of Cat S and HOMA-IR.Methods From October 2017 to June 2019,77 pregnant women with GDM underwent elective cesarean section were selected as GDM group,and 82 pregnant women with normal glucose tolerance during elective cesarean section were selected as control group.The fasting serum glucose(FPG),fasting insulin(Fin),total cholesterol(TC)and triglyceride(TG)were measured by automatic biochemical analyzer,the insulin resistance index was calculated.The serum Cat S level was assessedby ELISA.The correlations between serum Cat S level and HOMA-IR,TC,or TG levels were analyzed by Pearson method;the influencing factors of HOMA-IR were analyzed by multiple linear regression;and the risk factors of GDM were analyzed by binary logistic regression.Results Compared with the control group,the levels of BMI2,BMI3,TG,FBG,FINS and HOMA-IR in GDM group were significantly higher(P<0.05).Compared with the control group,the level of Cat S in GDM group was significantly higher(P<0.05).Pearson correlation showed that serum Cat S level was positively correlated with BMI3,TG,FINS and HOMA-IR levels(P<0.05).BMI3,FBG,FINS and Cat S were the influencing factors of HOMA-IR(P<0.05);and the increases of BMI3,Cat S,HOMA-IR,and TG were risk factors for GDM(OR=1.358,2.035,1.898,and 0.939,respectively;P<0.05).Conclusion The level of serum Cat S in patients with GDM is increased,which is positively correlated with HOMA-IR.It is of great significance to monitor the level of serum Cat S during pregnancy.