孕产妇血清和肽素水平变化对妊娠期糖尿病的诊断价值

Diagnostic Value of Serum and Peptide Levels in Pregnant Women in Gestational Diabetes Mellitus

目的探讨孕产妇血清和肽素水平变化对妊娠期糖尿病的诊断价值。方法选取2020年3月—2021年8月该院收治的40例妊娠期糖尿病患者(观察组)以及同期正常妊娠者40名(对照组)为研究对象。比较整个孕期两组血清和肽素及血糖指标变化,比较确诊妊娠期糖尿病患者不同孕期胰岛素抵抗指数和糖化血红蛋白水平,针对和肽素水平与空腹血糖、餐后2 h血糖、胰岛素抵抗指数及糖化血红蛋白变化进行相关性分析,比较和肽素单独及其联合空腹血糖、胰岛素抵抗指数及糖化血红蛋白诊断妊娠期糖尿病的ROC曲线,并计算AUC面积。结果整个孕期观察组和肽素水平低于对照组,差异有统计学意义(P<0.05),空腹血糖和餐后2 h血糖水平均高于对照组,差异有统计学意义(P<0.05),胰岛素抵抗指数及糖化血红蛋白在孕早期、孕中期和孕晚期均呈现逐渐升高趋势,差异有统计学意义(P<0.05),和肽素水平与空腹血糖、餐后2 h血糖、胰岛素抵抗指数及糖化血红蛋白变化均呈负相关性(P<0.05),和肽素单独及其联合空腹血糖、胰岛素抵抗指数及糖化血红蛋白诊断妊娠期糖尿病的AUC面积分别为0.685、0.714、0.833和0.596。结论血清和肽素检测能较为敏感的诊断妊娠期糖尿病,其联合胰岛素抵抗指数进行诊断则具有更理想的诊断价值。

Objective To investigate the diagnostic value of serum and peptide levels in pregnant women with gestational diabetes mellitus.Methods 40 patients with gestational diabetes mellitus(observation group)and 40 normal pregnancies(control group)admitted to the hospital from March 2020 to August 2021 were selected as the research objects.The changes of serum and peptidin and blood glucose indexes were compared between the two groups during the whole pregnancy,and the insulin resistance index and glycosylated hemoglobin levels were compared between the patients diagnosed with gestational diabetes during different pregnancies.The correlation analysis was conducted between the levels of peptidin and fasting blood glucose,2 h postprandial blood glucose,insulin resistance index and glycosylated hemoglobin.ROC curves of and peptidin alone and in combination with fasting glucose,insulin resistance index and glycated hemoglobin for the diagnosis of gestational diabetes mellitus were compared,and AUC area was calculated.Results The levels of copeptin in the observation group were lower than those in the control group during the whole pregnancy,the difference was statistically significant(P<0.05);fasting blood glucose and 2 h postprandial blood glucose levels were higher than those in control group,the difference was statistically significant(P<0.05).Insulin resistance index and HbA1c showed a gradually increasing trend in early,middle and late pregnancy,the difference was statistically significant(P<0.05).And copeptin levels were negatively correlated with fasting blood glucose,2 h postprandial blood glucose,insulin resistance index and glycosylated hemoglobin(P<0.05).The AUC areas of serum copeptin alone and in combination with fasting blood glucose,insulin resistance index and glycosylated hemoglobin for diagnosing gestational diabetes were 0.685,0.714,0.833 and 0.596,respectively.Conclusion Serum and peptide detection can be more sensitive in the diagnosis of gestational diabetes mellitus,and combined with insulin resistance index has more ideal diagnostic value.