妊娠糖尿病患者妊娠期血清鸢尾素水平与巨大儿的相关性

Correlation Between the Serum Irisin Level and Giant Infant in Patients with Gestational Diabetes Mellitus

目的分析妊娠糖尿病患者妊娠期血清鸢尾素水平与巨大儿的相关性。方法选取2018年7月至2020年11月河南省人民医院豫东分院收治的42例发生巨大儿的妊娠糖尿病患者作为巨大儿组,选取同期收治的42例未发生巨大儿的妊娠糖尿病患者作为非巨大儿组。所有患者入院时均接受血清鸢尾素检测,并使用超声仪测定胎儿双顶径、腹围及股骨长,测定患者空腹血糖、糖化血红蛋白水平。分析妊娠糖尿病患者妊娠期血清鸢尾素水平、空腹血糖、糖化血红蛋白与巨大儿的相关性;分析血清鸢尾素水平、空腹血糖、糖化血红蛋白对妊娠糖尿病患者发生巨大儿的影响;绘制受试者工作特征(ROC)曲线,分析血清鸢尾素水平、空腹血糖、糖化血红蛋白对妊娠糖尿病患者发生巨大儿的预测价值。结果巨大儿组血清鸢尾素水平低于非巨大儿组,空腹血糖、糖化血红蛋白、胎儿双顶径、腹围及股骨长高于非巨大儿组,差异有统计学意义(P<0.05)。双变量Pearson直线相关检验结果显示,妊娠糖尿病患者血清鸢尾素水平与患者空腹血糖、糖化血红蛋白水平、胎儿双顶径、腹围及股骨长呈负相关(r<0,P<0.05)。logistic回归分析结果显示,血清鸢尾素高是妊娠糖尿病患者发生巨大儿的保护因素(OR<1,P<0.05)、空腹血糖、糖化血红蛋白是妊娠糖尿病患者发生巨大儿的危险因素(OR>1,P<0.05)。绘制ROC曲线,结果显示血清鸢尾素、空腹血糖、糖化血红蛋白预测妊娠糖尿病患者发生巨大儿的曲线下面积(AUC)>0.7,具有较高的价值。结论妊娠糖尿病患者妊娠期血清鸢尾素水平与巨大儿密切相关,且可预测巨大儿的发生风险。

Objective To analyze the correlation between the serum irisin level and giant infant in patients with gestational diabetes mellitus.Methods The clinical data of 42 patients with gestational diabetes mellitus who had giant infants in Yudong Branch of Henan Provincial People’s Hospital from July 2018 to November 2020 were analyzed retrospectively,and included in the giant infant group.A total of 42 patients with gestational diabetes mellitus who did not have giant infant were selected at the same time,and were included in the non-giant group.All patients were tested for serum irisin at admission,the fetal diameter,abdominal circumference and femur length were measured by ultrasonic instrument,the fasting blood glucose and glycosylated hemoglobin levels of patients were measured.The correlation between serum irisin,fasting blood glucose,glycosylated hemoglobin and giant infant in patients with gestational diabetes mellitus was analyzed.The influence of serum irisin level,fasting blood glucose and glycosylated hemoglobin on the occurrence of giant infant in patients with gestational diabetes mellitus were analyzed.Receiver operating characteristic(ROC)curve was drawn,and the predictive value of serum iridoin level,fasting blood glucose and glycosylated hemoglobin on the occurrence of giant infants in patients with gestational diabetes mellitus were analyzed.Results The serum irisin level of patients in the giant infant group was lower than that of the non-giant infant group,and the fasting blood glucose,glycosylated hemoglobin,fetal double apex diameter,abdominal circumference and femur length were higher than those in the non-giant infant group(P<0.05).Through bivariate Pearson linear correlation test,the results showed that the serum iridoin level in gestational diabetes mellitus was negatively correlated with fasting blood glucose,glycosylated hemoglobin level,fetal double apex diameter,abdominal circumference and femur length(r<0,P<0.05).The results of logistic regression analysis showed that high serum irisin was a protective factor for giant infants(OR<1,P<0.05),and fasting blood glucose and glycosylated hemoglobin were risk factors for giant infants(OR>1,P<0.05)in patients with gestational diabetes.The ROC curve showed that the area under curve(AUC)of serum i irisin level,fasting blood glucose and glycosylated hemoglobin in predicting the giant infant in patients with gestational diabetes mellitus were>0.7,which had higher value.Conclusion The serum irisin level in patients with gestational diabetes mellitus is closely related to the giant infant,and it can predict the risk of giant infant.