妊娠期糖尿病患者孕晚期阴道微生态状况、血清网膜素、促代谢因子水平变化及临床意义

Changes and significance of vaginal microecological status and levels of serum omentin andβ-trophin in late pregnancy of patients with gestational diabetes mellitus

目的:探讨妊娠期糖尿病患者孕晚期阴道微生态状况、血清网膜素(Omentin)、促代谢因子(β-trophin)水平变化及意义。方法:纳入136例妊娠期糖尿病患者作为观察组,另选取同期进行检查的正常妊娠孕妇60例作为对照组,检测两组孕妇孕晚期时阴道微生态状态、血清Omentin、β-trophin水平;经Logistic回归分析血清Omentin、β-trophin与妊娠期糖尿病发病的关系,根据阴道微生态情况将136例妊娠期糖尿病患者分为阴道微生态失调亚组和阴道微生态正常亚组,比较两个亚组血清Omentin、β-trophin水平,绘制受试者工作特征曲线(ROC)评估血清Omentin、β-trophin水平对妊娠期糖尿病患者阴道微生态失调的诊断价值。结果:孕晚期时,观察组阴道微生态失调比例、β-trophin水平明显高于对照组,Omentin水平明显低于对照组(均P<0.05);Logistic回归分析显示,血清Omentin、β-trophin与妊娠期糖尿病的发病相关(均P<0.05);136例妊娠期糖尿病患者中67例阴道微生态失调者为阴道微生态失调亚组,69例阴道微生态正常者为阴道微生态正常亚组,阴道微生态失调亚组Omentin水平明显低于阴道微生态正常亚组,β-trophin水平明显高于阴道微生态正常亚组(均P<0.05);血清Omentin、β-trophin联合检测诊断妊娠期糖尿病患者阴道微生态失调的曲线下面积(AUC)分别为0.759、0.719、0.833。结论:妊娠期糖尿病患者孕晚期阴道微生态失调比例较高,血清Omentin水平降低,β-trophin升高,两者不仅与妊娠期糖尿病发病有关,也能够一定程度反应妊娠期糖尿病患者阴道微生态状态。

Objective:To explore the changes and significance of vaginal microecological status and levels of serum omentin andβ-trophin in late pregnancy of patients with gestational diabetes mellitus.Methods:A total of 136 patients with gestational diabetes mellitus were included in observation group,and 60 normal pregnant women during the same period were selected as control group.Vaginal microecological status and levels of serum omentin andβ-trophin in late pregnancy were detected in the two groups.The relationship between serum omentin,β-trophin and onset of gestational diabetes mellitus was analyzed by Logistic regression analysis.According to the vaginal microecology,136 patients with gestational diabetes mellitus were divided into vaginal microecological disorder subgroup and normal vaginal microecology subgroup.Serum omentin andβ-trophin levels were compared between the two subgroups,and ROC curve was drawn to evaluate the diagnostic value of serum omentin andβ-trophin levels on vaginal microecological disorder in patients with gestational diabetes mellitus.Results:In late pregnancy,the proportion of vaginal microecological disorder and the level ofβ-trophin in the observation group were significantly higher than those in the control group,while the level of omentin was significantly lower than that in the control group(all P<0.05).Logistic regression analysis showed that serum omentin andβ-trophin were correlated with the onset of gestational diabetes mellitus(all P<0.05).Among the 136 patients with gestational diabetes mellitus,there were 67 cases of vaginal microecological disorder in vaginal microecological disorder subgroup and 69 cases of normal vaginal microecology in normal vaginal microecology subgroup.The level of omentin in vaginal microecological disorder subgroup was significantly lower while the level ofβ-trophin was significantly higher in comparison with normal vaginal microecology subgroup(all P<0.05).The AUCs of serum omentin,β-trophin and combined detection in the diagnosis of vaginal microecological disorder in patients with gestational diabetes mellitus were 0.759,0.719 and 0.833 respectively.Conclusion:The proportion of vaginal microecological disorder in late pregnancy is higher in patients with gestational diabetes mellitus,the level of serum omentin is decreased,while the level ofβ-trophin is increased.The two levels are not only related to the onset of gestational diabetes mellitus,but also can reflect the vaginal microecological status in patients with gestational diabetes mellitus to a certain extent.