妊娠期糖尿病孕妇血清HDAC2、BDNF水平及预测新生儿不良结局价值

Levels of serum histone deacetylase 2 and brain derived neurotrophic factor of pregnant women with gestational diabetes mellitus and their values for predicting the adverse neonatal outcomes

目的:探讨妊娠期糖尿病(GDM)孕妇血清组蛋白去乙酰化酶2(HDAC2)、脑源性神经营养因子(BDNF)水平及预测新生儿不良结局价值。方法:收集2020年12月-2022年12月本院收治的GDM孕妇120例临床资料为GDM组,根据新生儿结局分为良好组75例与不良组45例,同期健康孕妇120例为对照组,检测血清HDAC2、BDNF水平并分析与糖脂代谢指标的相关性,及对GDM孕妇不良新生儿结局诊断价值。结果:GDM组HbA1c、FBG、FINS、HOMA-IR及血清TG、TC水平均高于对照组,血清HDAC2水平(32.25±6.53 ng/ml)高于对照组(18.56±4.63 ng/ml),BDNF水平(1.32±0.35 ng/ml)低于对照组(1.95±0.42 ng/ml)(均P<0.05);相关性分析,GDM患者血清HDAC2与HbA1c、FBG、FINS、HOMA-IR、TG、TC呈正相关,BDNF与HbA1c、FBG、FINS、HOMA-IR、TG、TC呈负相关(均P<0.05);新生儿结局不良组血清HDAC2水平高于良好组,BDNF水平低于良好组(均P<0.05);血清HDAC2、BDNF联合诊断GDM孕妇不良新生儿结局的曲线下面积为0.931,敏感度91.1%,特异度82.7%,联合诊断效能高于单独指标检测(P<0.05)。结论:GDM患者血清HDAC2水平异常升高、BDNF水平异常降低,且水平与糖脂代谢指标具有相关性,可能作为预测GDM孕妇新生儿不良结局的标志物。

Objective:To investigate the levels of serum histone deacetylase 2(HDAC2)and brain derived neurotrophic factor(BDNF)of pregnant women with gestational diabetes mellitus(GDM)and their values for predicting the ad-verse neonatal outcomes of the women.Methods:The clinical data of 120 pregnant women with GDM from December 2020 to December 22 were collcted and these women were included in observation subjects.According to the neonatal outcomes,these women were divided into group A(75 cases with normal neonatal outcomes)and group B(45 cases with adverse neonatal outcomes).120 healthy pregnant women were included in control group during the same period.The levels of serum HDAC2 and BDNF of the women in these groups were detected,and the correlation between which and the glycolipid metabolism indexes of the women was analyzed.The diagnostic values of the levels of serum HDAC2 and BDNF of the women with GDM for their adverse neonatal outcomes were also analyzed.Results:The lev-els of serum HbAlc,FBG,FINS,TG,and TC,and the HOMA IR value of the women in the observation group were significantly higher than those of the women in the control group.The level of serum HDAC2(32.25±6.53 ng/ml)of the women in the observation group was significantly higher than that(18.56±4.63 ng/ml)of the women in the con-trol group,but the level of BDNF(1.32±0.35 ng/ml)of the women in the observation group was significantly lower than that(1.95±0.42 ng/ml)of the women in control group(P<0.05).Correlation analysis showed that the level of serum HDAC2 of the women with GDM was positively correlated with their levels of HbAlc,FBG,FINS,TG,and TC,and HOMA IR value.The BDNF level of the women with GDM was negatively correlated with their levels of HbAlc,FBG,FINS,TG,and TC,and HOMA IR value(all P<0.05).The serum HDAC2 level of the women in group B was significantly higher than that of the women in group A,and the serum BDNF level of the women in group B was significantly lower(all P<0.05).The area under the curve,the sensitivity,and the specificity of the combined serum HDAC2 and BDNF levels of the women with GDM for diagnosing their adverse neonatal outcomes were 0.931,91.1%,and 82.7%,respectively.The diagnostic efficacy of the combined serum HDAC2 and BDNF levels of the women was significantly higher than that of the serum HDAC2 level and the BDNF level alone(P<0.05).Conclusion:The serum HDAC2 level of the women with GDM is increased and the BDNF level is decreased abnormally,and both of which are related to their glucolipid metabolism indexes,and which may be used as the markers to predict the ad-verse neonatal outcomes of the women.