Omentin-1、SFRP5、miR-17-5p在高龄妊娠期糖尿病患者中的表达及相关性研究

Expression and correlation of Omentin-1,SFRP5 and miR-17-5p in elderly patients with gestational diabetes mellitus

目的探析网膜素-1(Omentin-1)、分泌型卷曲相关蛋白5(SFRP-5)、微小RNA(miR)-17-5p在高龄妊娠期糖尿病(GDM)患者中的表达及相关性。方法选择该院2021年3月至2022年3月就诊的40例高龄GDM患者作为观察组,选择同期接受产检的40例健康高龄孕妇作为对照组。所有研究对象采用酶联免疫吸附试验检测Omentin-1、SFRP5,采用实时荧光定量聚合酶链反应(qRT-PCR)检测miR-17-5p。对比两组孕妇临床特征,包括一般资料、口服葡萄糖耐量试验2 h(OGTT 2 h)、胰岛素抵抗指数(HOMA-IR)、Omentin-1、SFRP5、miR-17-5p表达;采用Logistic回归模型分析GDM独立影响因素;采用Spearman分析Omentin-1、SFRP5、miR-17-5p与GDM患者HOMA-IR的相关性;采用受试者工作特征(ROC)曲线分析Omentin-1、SFRP5、miR-17-5p单项及联合诊断GDM效能。结果两组患者的年龄、体质量指数(BMI)、OGTT 2 h、HOMA-IR、Omentin-1、SFRP5、miR-17-5p指标比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,高BMI、高HOMA-IR、低表达Omentin-1、低表达SFRP5、高表达miR-17-5p为GDM的独立危险因素(P<0.05),GDM患者HOMA-IR与血清Omentin-1、SFRP5呈负相关(r=-0.498、-0.643,P<0.05)。而与miR-17-5p呈正相关(r=0.731,P<0.05)。ROC曲线结果显示,Omentin-1、SFRP5、miR-17-5p联合的曲线下面积(AUC)为0.867(95%CI:0.753~0.942),且高于单项检测指标(P<0.05);联合检测的灵敏度、特异度分别为87.43%、77.69%,具有较高诊断价值。结论Omentin-1、SFRP5、miR-17-5p为高龄GDM的独立影响因素,血清Omentin-1、SFRP5与HOMA-IR呈负相关,miR-17-5p与HOMA-IR呈正相关;且Omentin-1、SFRP5、miR-17-5p联合诊断效能优于单项指标诊断。

Objective To explore the expression and correlation of omentin-1(Omentin-1),secreted frizzled-related protein 5(SFRP-5)and microRNA(miR)-17-5p in elderly patients with gestational diabetes mellitus(GDM).Methods A total of 40 elderly GDM patients who visited the hospital from March 2021 to March 2022 were selected as the observation group,and 40 healthy elderly pregnant women who received obstetric examination during the same period were selected as the control group.All subjects were detected Omentin-1 and SFRP5 by enzyme-linked immunosorbent assay,and miR-17-5p was detected by real-time quantitative polymerase chain reaction(qRT-PCR).The clinical characteristics,including general information,oral glucose tolerance test 2 h(OGTT 2 h),insulin resistance index(HOMA-IR),and expressions of Omentin-1,SFRP5,and miR-17-5p,were compared between the two groups of pregnant women.Logistic regression model was used to analyze the independent influencing factors of GDM.Spearman was used to analyze the correlation between Omentin-1,SFRP5,miR-17-5p and HOMA-IR in patients with GDM.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of single and combined detection of Omentin-1,SFRP5,miR-17-5 pin the diagnosis of GDM.Results There were significant differences in age,body mass index(BMI),OGTT 2 h,HOMA-IR,Omentin-1,SFRP5,and miR-17-5p between the two groups(P<0.05).Logistic regression analysis showed that high BMI,high HOMA-IR,low expression of Omentin-1,low expression of SFRP5,and high expression of miR-17-5p were independent risk factors for GDM(P<0.05).HOMA-IR in DM patients was negatively correlated with serum Omentin-1 and SFRP5(r=-0.498,-0.643,P<0.05),and was positively correlated with miR-17-5p(r=0.731,P<0.05).ROC curve results showed that theAUC of combined detectionof Omentin-1,SFRP5 and miR-17-5p was 0.867(95%CI:0.753-0.942),which was higher than those of single detection(P<0.05).The sensitivity and the specificity of combined detectionwere 87.43%and 77.69%,respectively,with high predictive value.Conclusion Omentin-1,SFRP5 and miR-17-5p are independent influencing factors of GDM in advanced patients.Serum Omentin-1 and SFRP5 are negatively correlated with GDM in advanced patients,and miR-17-5p is positively correlated with GDM in advanced patients.The diagnosis efficacy of combined detectionof Omentin-1,SFRP5 and miR-17-5p is better than that of single detection.