妊娠期糖尿病患者氧化应激水平及对妊娠结局的影响

Oxidative stress and its effect on pregnancy outcome in patients with gestational diabetes mellitus

目的探讨妊娠期糖尿病(GDM)患者氧化应激水平及对妊娠结局的影响。方法选取34例GDM患者设为GDM组;另选取同期37例正常孕妇设为对照组。检测两组空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)水平,同时检测血清人活性氧(ROS)、核转录因子E_(2)相关因子(NRF_(2))、超氧化物歧化酶(SOD)及还原型谷胱甘肽(GSH)水平。比较两组氧化应激指标水平,分析ROS和NRF_(2)水平,探讨GDM患者氧化应激水平及对妊娠结局的影响。结果两组HbA1c水平比较,差异无统计学意义(P>0.05),GDM组FBG、FINS、HOMA-IR均高于对照组,差异有统计学意义(P<0.05)。GDM组胎儿不良妊娠结局发生率38.24%高于对照组的16.22%,差异有统计学意义(P<0.05)。GDM组ROS表达水平明显高于对照组,NRF_(2)表达水平低于对照组,差异有统计学意义(P<0.05),两组SOD、GSH表达水平比较,差异无统计学意义(P>0.05)。血清ROS和NRF_(2)对GDM不良妊娠结局有预测效能,其中ROS的预测效能最佳(P<0.001)。结论GDM患者存在氧化应激,氧化应激可导致不良妊娠结局。

Objective To investigate the effects of oxidative stress on pregnancy outcome in gestational diabetes mellitus(GDM).Methods 34 patients with GDM were selected as GDM group.37 normal pregnant women in the same period were selected as control group.Fasting blood glucose(FBG),fasting insulin(FINS)and glycosylated hemoglobin(HbAlc)levels were detected,while serum human reactive oxygen species(ROS),nuclear transcription factor E_(2)-related factors(NRF_(2)),superoxide dismutase(SOD)and reduced glutathione(GSH)levels were detected.Oxidative stress index levels were compared between the two groups,ROS and NRF_(2) levels were analyzed,and the effects of oxidative stress levels on pregnancy outcome in GDM patients were discussed.Results There was no significant difference in HbAlc level between the two groups(P>0.05),while FBG,FINS and HOMA-IR in GDM group were higher than those in control group,the difference was statistically significant(P<0.05).The incidence of adverse pregnancy outcome in GDM group was 38.24%higher than that in control group(16.22%),and the difference was statistically significant(P<0.05).The ROS expression level in GDM group was significantly higher than that in control group,and the NRF_(2) expression level was lower than that in control group,with statistical significance(P<0.05).There was no statistical significance in SOD and GSH expression levels between the two groups(P>0.05).Serum ROS and NRF_(2) had predictive efficacy for GDM adverse pregnancy outcomes,and ROS had the best predictive efficacy(PV0.001).Conclusion Peroxidation stress exists in patients with gestational diabetes mellitus,and oxidative stress can lead to adverse pregnancy outcomes.