孕早期血清P-LAP、NSF-1水平预测妊娠期糖尿病价值

Predictive value of the serum placental leucine aminopeptidase and nesfatin 1levels of pregnant women during the first trimester of pregnancy for their gestational diabetes mellitus

目的:探讨妊娠早期血清胎盘亮氨酸氨基肽酶(P-LAP)、摄食抑制因子(NSF-1)对妊娠期糖尿病(GDM)的预测价值。方法:选取2020年1月—2020年6月在本院接受产前检查的孕早期女性,于妊娠6~12周采集晨空腹静脉血,测定血清P-LAP、NSF-1水平及糖脂代谢指标。于妊娠24~28周行GDM筛查,分为GDM组与糖耐量正常组。比较两组各项临床资料差异,采用logistic回归模型分析GDM的影响因素,应用受试者工作特征(ROC)曲线评价各项指标对GDM的预测效能。结果:共纳入284l例孕妇,其中有61例诊断为GDM,发生率为21.5%。相比正常组,GDM组妊娠期体质指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)及血清NSF-1水平更高,P-LAP水平更低(均P<0.05)。logistic回归分析,P-LAP、NSF-1水平异常是GDM发病的独立影响因素(P<0.05)。ROC曲线分析显示,血清P-LAP、NSF-1预测GDM的曲线下面积(AUC)分别为0.799、0.808,敏感度(95.1%、52.9%)和特异度(65.6%、88.3%),二项联合预测GDM的AUC为0.872,敏感度78.7%,特异度81.2%。结论:孕早期血清P-LAP降低和NSF-1增高是GDM的独立危险因素,且对GDM的发病有较好预测价值。

Objective:To investigate the predictive value of the levels of serum placental leucine aminopeptidase(PLAP)and nesfatin 1(NSF-1)of pregnant women during the first trimester of pregnancy for their gestational diabetes mellitus(GDM).Methods:The pregnant women during the first trimester of pregnancy who received prenatal examination in hospital were selected as the research objects from January 2020to June 2020.The fasting venous blood in the morning of these women during 6-12gestational weeks was collected to detect the serum P-LAP and NSF-1levels and the glucose and lipid metabolism indicators values of the women.The GDM screening was performed for the women during 24-28gestational weeks,and based on the GDM screening results,the women were divided into group A(women with GDM)and group B(women with normal glucose tolerance(NGT)).The clinical data of the women were compared between the two groups.Logistic regression model was used to analyze the influencing factors of GDM,and receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the serum P-LAP and NSF-1levels of the women for their GDM.Results:A total of 284lpregnant women were included in this study,of which,61women were diagnosed as GDM,with the incidence of 21.5%.The body mass index(BMI)value,the levels of fasting blood glucose(FPG),glycated hemoglobin(HbA1c),fasting insulin(FINS),and serum NSF-1of the women in group A were significantly higher than those of the women in group B,and the P-LAP level of the women in group A was significantly lower(all P<0.05).Logistic regression analysis showed that the abnormal P-LAP and NSF?1levels of the women were the independent factors influencing their GDM occurrence(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the serum P-LAP level and the NSF-1level of the women for predicting their GDM were 0.799and 0.808,the sensitivity of which were 95.1%and 52.9%,and the specificity of which were 65.6%and 88.3%.The AUC,the sensitivity,and the specificity of the combined serum P-LAP and NSF?1levels of the women for predicting their GDM were 0.872,78.7%,and 81.2%,respectively.Conclusion:Both the decrease of the serum P-LAP level and the increase of the NSF-1level of the pregnant women during the first trimester of pregnancy are the independent risk factors of their GDM,and which have high predictive value for the GDM occurrence of these women.