孕早期血清Asprosin和Omentin-1对妊娠期糖尿病的预测价值

Predictive value of serum Asprosin and Omentin-1 in the first trimester for gestational diabetes mellitus

目的探讨孕早期血清白脂素(Asprosin)和网膜素-1(Omentin-1)对妊娠期糖尿病(GDM)的预测价值。方法选取2018年10月至2019年12月在宜宾市第一人民医院产科定期进行常规孕期检查的单胎孕妇560例。于妊娠8~12周测定孕妇血清Asprosin和Omentin-1水平,于妊娠24~28周行75g口服葡萄糖耐量试验(OGTT),根据OGTT结果将孕妇分为GDM组(n=109)与对照组(糖耐量正常,n=451)。比较两组孕妇孕早期血清Asprosin和Omentin-1水平,分析孕早期血清Asprosin、Omentin-1水平与空腹血糖、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)的相关性;采用多因素Logistic回归分析GDM发生的独立危险因素;采用受试者工作特征曲线(ROC)评估孕早期血清Asprosin、Omentin-1水平对GDM的预测价值。结果GDM组孕早期血清Asprosin水平高于对照组,血清Omentin-1水平低于对照组(t值分别为13.745、-14.014,P<0.05)。Pearson相关分析显示,孕早期血清Asprosin水平与空腹血糖、FINS、HOMA-IR呈正相关(r值分别为0.376、0.298、0.356,P<0.05);孕早期血清Omentin-1水平与空腹血糖、FINS、HOMA-IR呈负相关(r值分别为-0.516、-0.305、-0.292,P<0.05)。多因素Logistic回归分析显示,血清Asprosin(OR=2.982,95%CI=1.976~4.263)水平是GDM发生的独立危险因素,血清Omentin-1(OR=0.685,95%CI=0.469~0.832)水平是GDM发生的保护因素(P<0.05)。孕早期血清Asprosin和Omentin-1联合检测预测GDM的曲线下面积为0.924(95%CI=0.901~0.948),敏感度和特异度分别为93.5%和85.6%。结论孕早期血清Asprosin、Omentin-1水平与GDM的发生存在一定的相关性,两者联合检测对GDM具有较高的预测价值。

Objective To explore the predictive value of serum Asprosin and Omentin-1 in the first trimester for gestational diabetes mellitus(GDM).Methods A total of 560 singleton pregnant women with routine pregnancy examinations in the obstetrics department of the First People′s Hospital of Yibin from October 2018 to December 2019 were selected.Serum Asprosin and Omentin-1 were measured at 8-12 weeks of gestation.The oral glucose tolerance test(OGTT)was performed at 24-28 weeks of gestation.According to OGTT results,pregnant women were divided into the GDM group(109 cases)and the control group with the normal glucose tolerance(451 cases).The levels of serum Asprosin and Omentin-1 in the first trimester were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between serum Asprosin,Omentin-1 levels and fasting blood glucose(FBG),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR).Multivariate Logistic regression analysis was used to determine the independent risk factors of GDM.Receiver operating characteristic curve(ROC)was used to further analyze the predictive value of serum Asprosin and Omentin-1 for GDM.Results The level of serum Asprosin in the first trimester in the GDM group was higher than that in the control group,serum Omentin-1 was lower than that in control group(t=13.745 and-14.014,respectively,P<0.05).Pearson correlation analysis showed that serum Asprosin level was positively correlated with FBG,FINS and HOMA-IR(r=0.376,0.298 and 0.356,respectively,P<0.05).The serum Omentin-1 level was negatively correlated with FBG,FINS and HOMA-IR(r=-0.516,-0.305 and-0.292,respectively,P<0.05).Multivariate Logistic regression analysis showed that serum Asprosin(OR=2.982,95%CI=1.976~4.263)level was an independent risk factor for GDM,and serum Omentin-1(OR=0.685,95%CI=0.469~0.832)level was an independent protective factor for GDM(P<0.05).The total area under the ROC curve predicted GDM by combined serum Asprosin and Omentin-1 was 0.924(95%CI=0.901~0.948),and the sensitivity and specificity were 93.5%and 85.6%,respectively.Conclusion There is a certain correlation between serum Asprosin and Omentin-1 levels in the first trimester and the occurrence of GDM.The combined detection of Asprosin and Omentin-1 has high a predictive value for GDM.