催乳素及其受体水平与妊娠期糖尿病产妇妊娠结局的相关性

Correlations between prolactin,prolactin receptor levels and pregnancy outcome in puerpera with gestational diabetes mellitus

目的研究催乳素(PRL)及其受体水平与妊娠期糖尿病(GDM)产妇妊娠结局的相关性。方法回顾性100例GDM产妇的临床资料,按照不良妊娠结局发生情况将其分为不良结局组(发生不良妊娠结局,n=42)和对照组(未发生不良妊娠结局,n=58)。比较2组PRL、胎盘催乳素(HPL)、催乳素受体(PRLR)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、餐后2 h血糖(2 hFBG)、糖血红蛋白(HbA1c)水平;采用受试者工作特征(ROC)曲线分析PRL、HPL和PRLR mRNA预测GDM产妇不良妊娠结局的价值;分析PRL、HPL、PRLR mRNA水平与不良妊娠发生率的相关性。结果GDM产妇不良结局发生率为42.00%,主要以巨大儿和胎儿窘迫为主。巨大儿和胎儿窘迫例数分别占不良结局产妇总例数的64.29%、16.67%。不良结局组PRL、HPL和PRLR mRNA水平低于对照组,差异有统计学意义(P<0.05)。PRL、HPL和PRLR mRNA预测GDM产妇不良妊娠结局的曲线下面积分别为0.763、0.855、0.791。PRL、HPL和PRLR mRNA水平与不良妊娠结局发生率呈显著负相关(P<0.05)。结论PRL、HPL和PRLR mRNA水平的异常表达均可能提示GDM产妇不良妊娠结局的发生。

Objective To study the correlations between prolactin(PRL),its receptor level and pregnancy outcome of puerpera with gestational diabetes mellitus(GDM).Methods The clinical data of 100 puerpera with GDM was retrospectively analyzed.According to the occurrence of adverse pregnancy outcomes,they were divided into adverse outcome group(adverse pregnancy outcomes,n=42)and control group(no adverse pregnancy outcomes,n=58).The levels of PRL,placental prolactin(HPL),prolactin receptor(PRLR),fasting blood glucose(FBG)and insulin resistance index(HOMA-IR),2 h postprandial blood glucose(2 hFBG)and glycosylated hemoglobin(HbA1c)were compared between the two groups;receiver operating characteristic(ROC)curve analysis was used to analyze the predictive value of PRL,HPL and PRLR mRNA in GDM maternal adverse pregnancy outcomes;the correlations between PRL,HPL as well as PRLR mRNA levels and the incidence of adverse pregnancy were analyzed.Results The incidence of adverse outcomes of GDM was 42.00%,mainly including macrosomia and fetal distress.The macrosomia and fetal distress accounted for 64.29%and 16.67%of the total cases of adverse outcomes,respectively.The levels of PRL,HPL and PRLR mRNA in the adverse outcome group were significantly lower than those in the control group(P<0.05).The area under the curve of PRL,HPL and PRLR mRNA in predicting adverse pregnancy outcome of GDM puerpera were 0.763,0.855 and 0.791,respectively.The levels of PRL,HPL and PRLR mRNA were significantly negatively correlated with the incidence of adverse pregnancy outcomes(P<0.05).Conclusion Abnormal expression of PRL,HPL and PRLR mRNA levels may indicate the occurrence of adverse pregnancy outcomes in GDM puerpera.