拉曼光谱在妊娠糖尿病诊断中的应用价值

Application of Raman spectroscopy in the diagnosis of gestational diabetes mellitus

目的探讨拉曼光谱在妊娠糖尿病(GDM)中的应用价值。方法选取29名非孕体检健康者(正常对照组)、29例正常妊娠妇女(正常妊娠组)和42例GDM患者,建立拉曼光谱诊断GDM的方法。另选取78例GDM患者和70名体检健康者进行方法验证。采用正交偏最小二乘回归(OPLS)、主成分分析(PCA)-支持向量机(SVM)及PCA-隐含狄利克雷分布(LDA)3种数学模型对拉曼光谱结果进行分类,并筛选出特征峰。采用受试者工作特征(ROC)曲线评价3种模型的分类能力,筛选最优模型,并与口服葡萄糖耐量试验(OGTT)进行比较。结果GDM患者、正常对照者及正常妊娠妇女在1005.86、1034.47、1087.64和1128.39 cm^(-1)处均出现较明显的拉曼光谱峰。GDM组在1005.86、1034.47、1128.39和1343.69 cm^(-1)处的拉曼光谱峰与正常对照组及正常妊娠组有明显差异。OPLS模型对GDM组、正常对照组及正常妊娠组的区分能力最佳。采用OPLS模型区分拉曼光谱诊断GDM的敏感性为97.43%、准确度为95.27%,高于OGTT法的91.03%和93.92%;但特异性为92.86%,低于OGTT法的97.14%。结论拉曼光谱结合OPLS模型具有较好的敏感性、特异性和准确度,或可作为GDM筛查和诊断的有效方法。

Objective To investigate the role of Raman spectroscopy in gestational diabetes mellitus(GDM).Methods A total of 29 non-pregnant healthy subjects,29 pregnant healthy subjects and 42 GDM patients were enrolled.Meanwhile,78 GDM patients and 70 healthy subjects were enrolled for verification.Orthogonal partial least square regression(OPLS),principal component analysis(PCA)based method support vector machine(SVM)and latent dirichlet allocation(LDA)were used to classify Raman spectra obtained.Receiver operating characteristic(ROC)curve was used to evaluate the classification ability of the 3 models,and the optimal model was selected.The new method was compared with oral glucose tolerance test(OGTT).Results Raman peaks appeared at 1005.86,1034.47,1087.64 and 1128.39 cm^(-1) in the GDM group,non-pregnant healthy group and pregnant healthy group,respectively.The Roman peaks in the GDM group at 1005.86,1034.47,1128.39 and 1343.69 cm^(-1) were significantly different from that in non-pregnant healthy group and pregnant healthy group.OPLS model had a good ability to distinguish GDM,non-pregnant healthy and pregnant healthy groups.The sensitivity and accuracy of OPLS model to distinguish GDM by Raman spectroscopy were 97.43%and 95.27%,respectively,which were higher than OGTT(91.03%and 93.92%).However,the specificity of OPLS was lower than that of OGTT(92.86%vs 97.14%).Conclusions Raman spectroscopy combined with OPLS model has high sensitivity,specificity and accuracy,It may be used for rapid screening of GDM.