血清成纤维细胞生长因子23与妊娠期糖尿病的相关性研究

Study on the correlation between serum fibroblast growth factor-23 and gestational diabetes mellitus

目的 分析血清成纤维细胞生长因子23(FGF-23)与妊娠期糖尿病的相关性。方法 选取2018年5月至2020年5月本院产科收治的111例产前检查的孕妇作为研究对象,其中合并妊娠糖尿病(GDM)者作为观察组(n=49),正常妊娠者作为对照组(n=62)。两组同时检测血糖、糖化血红蛋白(HbA1c)和血脂等指标,采取酶联免疫吸附法检测血清FGF-23水平,分析血清FGF-23与妊娠期糖尿病的相关性。结果 两组年龄、孕龄、餐后1 h C肽(1 h C-P)、餐后2 h C肽(2 h C-P)、新生儿体质量比较差异无统计学意义,两组体重指数、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、餐后1 h血糖(1 h PG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FIns)、HbA1c、空腹C肽(FC-P)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)比较差异均有统计学意义(P<0.05),且观察组FGF-23水平高于对照组(P<0.05);Pearson相关分析显示,血清FGF-23与年龄及HbA1c呈正相关(P<0.05)。校正年龄后,血清FGF-23与HbA1c仍呈正相关(P<0.05),进一步行亚组分析发现,观察组血清FGF-23与HbA1c、年龄呈正相关(P<0.05);经Logistic回归分析显示,血清FGF-23是GDM的影响因素(P<0.05)。结论 血清FGF-23水平升高可能参与GDM的发生和发展,临床上可通过加强对血清FGF-23的检测,更好地评估和治疗GDM疾病,以改善预后。

Objective To investigate the correlation between serum fibroblast growth factor-23(FGF-23) and gestational diabetes mellitus.Methods 111 cases of pregnant women undergoing prenatal obstetric examination in our hospital from May 2018 to May 2020 were selected as the research subjects, including 49 cases of gestational diabetes mellitus(GDM) as the observation group, and 62 cases of normal pregnancy as the control group. Blood glucose, glycated hemoglobin A1c(HbA1c) and blood lipid were detected at the same time in the two groups. The serum FGF-23 level was detected by enzyme-linked immunosorbent assay, and the correlation between serum FGF-23 and gestational diabetes mellitus was analyzed. Results The age, gestational week, 1 hour postprandial C-peptide(1 h C-P), 2 hours postprandial C-peptide(2 h C-P) and neonatal weight was no significant difference between two groups. There were significant differences in body mass index, systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting blood glucose(FBG), 1 hour postprandial blood glucose(1 h PG), 2 hours postprandial blood glucose(2 h PG), fasting insulin(FIns), HbA1c, asting C-peptide(FC-P), otal cholesterol(TC), triacylglycerol(TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) between the two groups(P<0.05), and the level of FGF-23 in the observation group was higher than that in the control group(P<0.05). The serum FGF-23 level was positively correlated with age and HbA1c(P<0.05). After adjusted for age,serum FGF-23 was still positively correlated with HbA1c(P<0.05). Further subgroup analysis showed that serum FGF-23 was positively correlated with HbA1c and age in the observation group(P<0.05). Logistic regression analysis showed that serum FGF-23 was the influencing factor of GDM(P<0.05). Conclusion Elevated serum FGF-23 levels may be involved in the occurrence and development of GDM, by strengthening the detection of serum FGF-23, GDM disease can be better evaluated and treated to improve prognosis.