炎症因子对妊娠期糖尿病妊娠结局的预测作用

The predictive effect of inflammatory adipocytokines on pregnancy outcome for gestational diabetes mellitus

目的探讨炎症因子与妊娠期糖尿病的相关性,并评价其对不良妊娠结局的预测作用。方法选择2018年9月至2020年1月于该院产科住院的妊娠期糖尿病患者318例,根据妊娠结局分两组:对照组256例、不良结局组62例。收集临床资料,采用酶联免疫吸附试验法检测血清炎症因子水平。分析炎症因子对妊娠期糖尿病妊娠结局的预测作用。结果不良结局组脂肪酸结合蛋白4(FABP4)、骨保护素(OPG)、白细胞介素6(IL-6)水平高于对照组,而不良结局组脂联素(ADPN)水平低于对照组,差异均有统计学意义(P<0.05)。相关分析结果显示,炎症因子与孕后体质量指数(BMI)及糖化清蛋白存在相关性(P<0.05);受试者工作特征曲线(ROC曲线)显示FABP4、ADPN、IL-6、OPG预测不良妊娠结局的最佳诊断界值分别为5.88、0.03763、0.03195、348.15 pg/L;多因素Logistic回归分析显示,FABP4>5.88 pg/L、IL-6>0.03195 pg/L、OPG>348.15pg/L、ADPN<0.03763 pg/L均为不良妊娠结局的独立危险因素。结论FABP4、ADPN、IL-6、OPG对妊娠期糖尿病患者妊娠结局具有预测作用。

Objective To explore the association between inflammatory adipocytokines and gestational diabetes mellitus and assess predictive value on pregnancy outcome.Methods A total of 256 cases were consecutively enrolled from September 2018 to January 2020 in the division of obstetrics in our hospital.According to the pregnancy outcomes,there were 62 patients with adverse pregnancy outcome(adverse pregnancy outcome group)and there were 256 patents with normal outcomes(control group).The concentrations of serum inflammatory adipocytokines were measured by enzyme-linked immunosorbent assay(ELISA).Results Levels of fatty acid binding protein 4(FABP4),osteoprotegerin(OPG)and interleukin-6(IL-6)of adverse pregnancy outcome group were significantly higher than that of control group(P<0.05),while the serum level of adiponectin(ADPN)was significantly lower than that of control group(P<0.05).Inflammatory adipocytokines were significantly correlated with the postpartum body mass index(BMI)and glycated albumin(P<0.05).In addition,receiver operating characteristic curve(ROC curve)showed that the cut-off points of FABP4,ADPN,IL-6 and OPG in predicting adverse pregnancy outcome were 5.88,0.03763,0.03195,348.15 pg/L.Multiple Logistic regression analysis showed that FABP4>5.88 pg/L,IL-6>0.03195 pg/L,OPG>348.15 pg/L,ADPN<0.03763 pg/L were independent risk factors of adverse pregnancy outcome.Conclusion FABP4,ADPN,IL-6,OPG and ADPN may be enlightening predictive markers for adverse pregnancy outcome.