血清miR-301a、miR-197与GDM患者炎性细胞因子的相关性及预测妊娠结局的ROC分析

Correlation between serum miR-301a,miR-197 and inflammatory cytokines in GDM patients and ROC analysis for predicting pregnancy outcome

目的探讨血清微小RNA-301a(miR-301a)、miR-197与妊娠期糖尿病(GDM)患者炎性细胞因子的相关性及预测妊娠结局的受试者工作特征曲线(ROC)分析。方法选取2020年1月—2021年1月于海南医学院第二附属医院产科行产检并分娩的确诊GDM孕妇45例为观察组,并按照妊娠结局分为良好亚组25例和不良亚组20例,另选取同时期在医院产检并分娩的健康孕妇45例为对照组。检测2组孕妇白细胞计数(WBC)及血清miR-301a、miR-197、白介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平,采用Pearson法分析血清miR-301a、miR-197与WBC、IL-1、IL-6、TNF-α、CRP的相关性,Logistic回归分析影响GDM患者妊娠结局的危险因素,绘制ROC曲线分析血清miR-301a、miR-197对GDM患者妊娠结局的预测价值。结果观察组血清miR-301a高于对照组,miR-197低于对照组(t=16.542、75.445,P均<0.001),WBC及血清IL-1、IL-6、TNF-α、CRP水平均高于对照组(t=9.297、40.910、31.633、14.860、12.258,P均<0.001);血清miR-301a与WBC、IL-1、IL-6、TNF-α、CRP水平呈正相关(r/P=0.523/<0.001、0.542/<0.001、0.325/0.009、0.196/0.002、0.145/0.034),血清miR-197与WBC、IL-1、IL-6、TNF-α、CRP水平呈负相关(r=-0.251、-0.673、-0.374、-0.258、-0.546,P均<0.001);血清miR-301a高表达、miR-197低表达均是影响GDM患者妊娠结局的独立危险因素[OR(95%CI)=22.692(2.056-250.385)、12.833(1.143-144.119)];血清miR-301a、miR-197及二者联合预测GDM患者妊娠结局的AUC分别为0.785、0.804、0.954,二者联合预测的AUC均高于单项检测(Z=5.239、4.263,P均<0.001)。结论血清miR-301a、miR-197的异常表达与妊娠期糖尿病的发生发展有关,二者联合检测对于预测妊娠结局的价值较高,可作为治疗妊娠期糖尿病的重要靶点。

Objective To explore the correlation between serum microRNA-301a(miR-301a),miR-197 and inflammatory cytokines in patients with gestational diabetes(GDM),and to analyze the receiver operating characteristic curve(ROC)that predicts pregnancy outcome.Methods From January 2020 to January 2021,45 pregnant women with GDM who were diagnosed and delivered in the Obstetrics Department of the Second Affiliated Hospital of Hainan Medical College were selected as the observation group,and were divided into 25 good subgroups and 20 bad subgroups according to pregnancy outcomes.Another 45 healthy pregnant women who were delivered in the hospital during the same period were selected as the control group.White blood cell count(WBC),serum miR-301a,miR-197,interleukin-1(IL-1),IL-6,and tumor necrosis factor were detected in the two groups of pregnant women-α(TNF-α),C-reactive protein(CRP)level,serum miR-301a,miR-197 and WBC,IL-1,IL-6,TNF-αwere analyzed by Pearson method,Correlation of CRP,logistic regression analysis of the risk factors affecting the pregnancy outcome of GDM patients,and ROC curve analysis of the predictive value of serum miR-301a and miR-197 on the pregnancy outcome of GDM patients.Results The serum miR-301a in the observation group was higher than that in the control group,and miR-197 was lower than that in the control group(t=16.542,75.445,P<0.001).WBC and serum IL-1,IL-6,TNF-α,CRP levels were higher than those in the control group(t=9.297,40.910,31.633,14.860,12.258,P<0.001).Serum miR-301a and WBC,IL-1,IL-6,TNF-α,CRP level was positively correlated(r/P=0.523/<0.001,0.542/<0.001,0.325/0.009,0.196/0.002,0.145/0.034).Serum miR-197 was associated with WBC,IL-1,IL-6,TNF-α,CRP levels were negatively correlated(r=-0.251,-0.673,-0.374,-0.258,-0.546,P<0.001).High expression of miR-301a and low expression of miR-197 in serum are independent risk factors affecting pregnancy outcome of GDM patients[OR(95%CI)=22.692(2.056-250.385),12.833(1.143-144.119)].The AUC of serum miR-301a,miR-197 and their combination in predicting the pregnancy outcome of GDM patients were 0.785,0.804 and 0.954,respectively.The AUC of their combination was higher than that of single detection(Z=5.239,4.263,P<0.001).Conclusion The abnormal expression of serum miR-301a and miR-197 is related to the occurrence and development of gestational diabetes.The combined detection of miR-301a and miR-197 is of high value in predicting pregnancy outcome,and can be used as an important target for the treatment of gestational diabetes.