网膜素-1在妊娠期糖尿病患者不同孕期及产后血清浓度及其临床价值

Serum concentration and clinical value of omentin-1 in patients with gestational diabetes mellitus at different stages of pregnancy and postpartum

目的探讨网膜素-1在妊娠期糖尿病(GDM)患者不同孕期和产后血清中的浓度及其临床价值。方法选取2019年7月至2021年6月本院产检及分娩的92例孕龄32~34周孕妇作为研究对象,按照OGTT检查结果分为GDM组与对照组,每组46例。两组于孕龄及产后不同时间点检测空腹胰岛素水平、空腹血糖水平及网膜素-1。比较两组不同孕龄及产后空腹血糖、网膜素-1、空腹胰岛素水平;Pearson相关性分析网膜素-1与空腹血糖、空腹胰岛素相关性;多因素Logistic回归分析GDM孕妇的危险因素。结果两组空腹血糖、网膜素-1、空腹胰岛素水平比较组间、时间、交互作用比较差异有统计学意义(P<0.05)。组内比较:GDM组孕龄及产后各时间点空腹血糖、空腹胰岛素水平高于前一时间点,网膜素-1水平低于前一时间点,差异有统计学意义(P<0.05);对照组孕龄及产后各时间点的空腹血糖、网膜素-1、空腹胰岛素水平两两比较差异无统计学意义。组间比较:孕龄32~34周、37~41周及产后24 h~1周、5~7周,GDM组空腹血糖、空腹胰岛素水平均高于对照组,网膜素-1水平均低于对照组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,网膜素-1与空腹血糖、空腹胰岛素呈负相关(r<0,P<0.05)。多因素Logistic回归分析结果显示,空腹血糖、空腹胰岛素及网膜素-1均为GDM发生的危险因素(OR>1,P<0.05)。结论GDM患者网膜素-1表达水平异常,且随着孕龄增加至产后呈下降趋势,说明GDM症状越严重,因此,其可作为GDM评估的临床指标,为GDM早期诊断与治疗方案的制订提供临床依据。

Objective To investigate the serum concentration and clinical value of omentin-1 in patients with gestational diabetes mellitus(GDM)at different stages of pregnancy and postpartum.Methods 92 pregnant women aged 32-34 weeks who underwent antenatal examination and delivery in our hospital from July 2019 to June 2021 were selected as study subjects,and they were divided into the GDM group and the control group according to OGTT examination results,with 46 cases in each group.Fasting insulin level,fasting blood glucose level and omentin-1 were detected at different time points of gestational age and postpartum.The levels of fasting blood glucose,omentin-1 and fasting insulin were compared between the two groups at different gestational age and postpartum;Pearson correlation analysis was used to analyze the correlation between omentin-1 and fasting blood glucose,fasting insulin;multivariate Logistic regression was used to analyze the risk factors of GDM.Results There were statistically significant differences in fasting blood glucose,omentin-1 and fasting insulin levels between two groups of group,time points and interaction(P<0.05).Comparison within the group:the fasting blood glucose and fasting insulin levels in the GDM group was higher than the previous time point,and the retinin-1 level was lower than the previous time point,and the differences were statistically significant(P<0.05);there were no significant differences in fasting blood glucose,retinin-1 and fasting insulin levels in the control group at gestational age and postpartum time points.Comparison between groups:at 32-34 weeks of gestation age,37-41 weeks of gestation age,24 h to 1 week after delivery,5-7 weeks after delivery,the fasting blood glucose,fasting insulin levels in the GDM group was higher than that in the control group,and the omentin-1 level was lower than that in the control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that omentin-1 was negatively correlated with fasting glucose and fasting insulin(r<0,P<0.05).Multivariate Logistic regression analysis showed that fasting blood glucose,fasting insulin and omentin-1 were risk factors for GDM(OR>1,P<0.05).Conclusion The expression level of retinin-1 in patients with GDM is abnormal and decreases with the increase of gestational age to postpartum,indicating that the symptoms of GDM are more serious.Therefore,it can be used as a clinical index for the evaluation of GDM and provide clinical basis for early diagnosis and treatment of GDM.