妊娠期亚临床甲状腺功能减退症患者血清胃饥饿素、肥胖抑制素水平与妊娠结局的关系

The relationship between serum Ghrelin and Obestatin levels and pregnancy outcomes in subclinical hypothyroidism during pregnancy

目的探讨妊娠期亚临床甲状腺功能减退症(SCH)患者血清胃饥饿素(Ghrelin)、肥胖抑制素(Obestatin)的表达水平及其与妊娠结局的关系。方法选取2017年1月至2018年1月在青海红十字医院产检的120例妊娠期SCH患者作为研究组,另选取在同一医院产检的122例健康孕妇作为对照组。采用酶联免疫吸附试验(ELISA)法检测两组血清Ghrelin、Obestatin水平;采用Pearson法分析妊娠期SCH患者血清Ghrelin、Obestatin的相关性;绘制受试者工作特征(ROC)曲线分析血清Ghrelin、Obestatin对妊娠期SCH患者发生不良妊娠结局的预测价值;采用Logistic回归分析影响妊娠期SCH患者发生不良妊娠结局的危险因素。结果与对照组比较,研究组患者血清Ghrelin水平降低(P<0.05),Obestatin水平升高(P<0.05)。低Ghrelin水平组患者不良妊娠结局的总发生率高于高Ghrelin水平组(P<0.05),高Obestatin水平组患者不良妊娠结局的总发生率高于低Obestatin水平组(P<0.05)。血清Ghrelin、Obestatin水平呈负相关(r=-0.480,P<0.05)。与血清Ghrelin、Obestatin单独检测比较,二者联合预测妊娠期SCH患者发生不良妊娠结局的曲线下面积(AUC)更高(Z=3.734、4.765,P=0.000);血清Ghrelin低水平、Obestatin高水平是妊娠期SCH患者发生不良妊娠结局的独立危险因素(P<0.05)。结论妊娠期SCH可增加不良妊娠结局的发生率,且血清Ghrelin表达水平越高,Obestatin表达水平越低,越容易发生不良妊娠结局。

Objective To investigate the expression levels of serum Ghrelin and Obestatin in patients with subclinical hypothyroidism(SCH)during pregnancy and their relationship with pregnancy outcome.Methods 120 SCH patients during pregnancy who were examined in Qinghai Red Cross Hospital from January 2017 to January 2018 were selected as the study group,and 122 healthy pregnant women who were examined in the same hospital were selected as the control group.Serum Ghrelin and Obestatin levels were detected by enzyme-linked immunosorbent assay(ELISA).The correlation of serum Ghrelin and Obestatin in SCH patients during pregnancy was analyzed by Pearson method.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Ghrelin and Obestatin for adverse pregnancy outcomes in SCH patients during pregnancy.Logistic regression was used to analyze the risk factors of adverse pregnancy outcomes in SCH patients during pregnancy.Results Compared with the control group,the serum Ghrelin level in the study group was decreased(P<0.05)and Obestatin level was increased(P<0.05).The overall incidence of adverse pregnancy outcomes in patients with low Ghrelin level was higher than that in patients with high Ghrelin level(P<0.05),and the overall incidence of adverse pregnancy outcomes in patients with high Obestatin level was higher than that in patients with low Obestatin level(P<0.05).Serum Ghrelin and Obestatin levels were negatively correlated(r=-0.480,P<0.05).Compared with serum Ghrelin and Obestatin alone,the area under curve(AUC)of combined Ghrelin and Obestatin in predicting adverse pregnancy outcomes in SCH patients during pregnancy was higher(Z=3.734,4.765,P=0.000).Low levels of serum Ghrelin and high levels of Obestatin were independent risk factors for adverse pregnancy outcomes in SCH patients during pregnancy(P<0.05).Conclusions SCH during pregnancy can increase the incidence of adverse pregnancy outcomes,and the higher the serum Ghrelin expression level,the lower the Obestatin expression level,the more likely to have adverse pregnancy outcomes.