25-(OH)D_(3)、脂联素、趋化素与妊娠期糖尿病患者胰岛素抵抗的相关性分析

Correlation between serum 25-(OH)D_(3),adiponectin,chemerin levels and insulin resistance in women with gestational diabetes

目的探讨25-羟基维生素D_(3)[25-(OH)D_(3)]、脂联素(APN)及趋化素与妊娠期糖尿病(GDM)患者胰岛素抵抗的相关性。方法选取2020年5月至2021年12月天津市中心妇产科医院就诊的GDM患者28例为GDM组,同期糖耐量正常的孕妇45例为对照组。比较2组患者的25-(OH)D_(3)、APN、趋化素、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)和稳态型胰岛素抵抗指数(HOMA-IR),并分析25-(OH)D_(3)、APN、趋化素与GDM患者胰岛素抵抗的相关性。结果GDM组FPG、FINS、HOMA-IR及趋化素高于对照组(均P<0.05),25-(OH)D_(3)和APN低于对照组(均P<0.05)。Logistic分析显示血清25-(OH)D_(3)、APN、趋化素均为GDM的相关影响因素(均P<0.05)。Spearman相关性分析显示血清25-(OH)D_(3)与FPG、HOMA-IR存在负相关(均P<0.05),趋化素与FINS、HOMA-IR存在正相关(均P<0.05)。ROC曲线分析结果显示25-(OH)D_(3)、APN和趋化素的AUC分别为0.841(95%CI:0.746~0.967)、0.678(95%CI:0.545~0.812)、0.360(95%CI:0.233~0.487)。结论25-(OH)D_(3)、APN和趋化素与GDM患者胰岛素抵抗有一定的相关性,对GDM的预测具有参考价值。

Objective To explore the correlation between the serum 25-(OH)D_(3),adiponectin(APN),and chemerin levels of pregnant women with gestational diabetes mellitus(GDM)and insulin resistance.Methods 28 pregnant women with GDM were selected for the study group from May 2020 to December 2021,and 45 pregnant women with normal glucose tolerance were selected for the control group.25-(OH)D_(3),APN,chemerin,islet resistance index(HOMA-IR),fasting blood glucose,fasting insulin,and HbA1c were compared between the two groups.The correlation between 25-(OH)D_(3),APN,chemerin,and GDM insulin resistance was analyzed.Results Fasting blood glucose,fasting insulin,HOMA-IR,and chemerin in the GDM group were higher than those in the control group(all P<0.05),while 25-(OH)D_(3)and APN were lower than those in the control group(all P<0.05).There was no statistical difference in HbA1c between the two groups.Logistic regression analysis showed that serum 25-(OH)D_(3),APN,and chemerin were all related influencing factors of GDM(all P<0.05).Spearman's correlation analysis showed that serum 25-(OH)D_(3)was negatively correlated with fasting blood glucose and HOMA-IR(all P<0.05),chemerin was positively correlated with fasting insulin and HOMA-IR(all P<0.05).ROC curve analysis showed that the AUC of 25-(OH)D_(3)was 0.841(95%CI:0.746~0.967).AUC of APN was 0.678(95%CI:0.545~0.812).AUC of chemerin AUC was 0.360(95%CI:0.233~0.487).Conclusions The levels of 25-(OH)D_(3),APN,and chemerin have a certain correlation with the pathogenesis of GDM,which has a certain reference value for the prediction of GDM.