妊娠期糖尿病孕早期血清中白细胞介素33表达水平和产后抑郁的相关性研究

Correlation between serum IL-33 level and postpartum depression in gestational diabetes mellitus during early pregnancy

目的探讨妊娠期糖尿病孕早期血清中IL-33表达水平预测产后抑郁的临床效能。方法纳入2021年1月—2022年6月于本院产科就诊的80例妊娠期糖尿病产妇和45例正常妊娠产妇分别作为妊娠期糖尿病组和对照组,检测并比较2组FPG、1 h PG、2 h PG和IL-33水平的差异。妊娠期糖尿病组孕早期血清IL-33表达水平和产后6周EPDS抑郁量表评分的相关性采用Pearson相关分析,分析妊娠期糖尿病组产后抑郁发生率,比较妊娠期糖尿病无产后抑郁、轻度产后抑郁和中-重度产后抑郁血清中IL-33表达水平的差异,血清IL-33表达水平预测产后抑郁发生率的临床效能采用ROC曲线分析。结果与对照组相比,妊娠期糖尿病组FPG、1 h PG、2 h PG和IL-33水平显著升高,差异有统计学意义(P<0.05)。妊娠期糖尿病产妇产后抑郁发生率为63.75%,血清IL-33表达水平预测妊娠期糖尿病发生产后抑郁的曲线下面积为0.896(95%CI:0.776~0.925),当截断值为211.76 ng/ml时,敏感度和特异度分别为86.56%和87.24%;血清IL-33表达水平预测妊娠期糖尿病发生产后中-重度抑郁的曲线下面积为0.812(95%CI:0.698~0.902),当截断值为231.55 ng/ml时,敏感度和特异度分别为78.98%和87.13%。结论妊娠期糖尿病孕早期血清中IL-33表达水平显著升高,IL-33表达水平可作为预测发生产后抑郁的一项血清学标志物。

Objective This study aims to investigate the clinical efficacy of serum IL-33 level in predicting the incidence of postpartum depression in gestational diabetes mellitus during early pregnancy.Methods A total of 80 pregnant women with gestational diabetes mellitus and 45 normal pregnant women in the Department of Obstetrics in our hospital between January 2021 and June 2022 were enrolled.All individuals were divided into gestational diabetes group and control group.The levels of FPG,1 h PG,2 h PG and IL-33 were detected and compared between the two groups.Pearson correlation analysis was used to explore the correlation between serum IL-33 level during the early pregnancy and EPDS depression scale score at 6 weeks postpartum in gestational diabetes mellitus group.The incidence of postpartum depression in gestational diabetes group was investigated.The difference of serum IL-33 expression in women without postpartum depression,mild postpartum depression and moderate to severe postpartum depression in gestational diabetes mellitus were analyzed and compared.The clinical efficacy of serum IL-33 expression in predicting the incidence of postpartum depression in gestational diabetes mellitus during the early pregnancy was analyzed by ROC curve.Results The levels of FPG,1 h PG,2 h PG and IL-33 in gestational diabetes melli⁃tus group were significantly increased compared to control group,with the difference statistically significant(P<0.05).The incidence of postpartum depression was 63.75%(51/80,63.75%)in women with gestational diabetes mellitus.The serum expression of IL-33 in women without postpartum depression,mild postpartum depression and moderate to severe postpartum depression were(178.95±11.69)mmol/L,(201.09±6.25)mmol/L and(227.06±12.72)mmol/L,respectively.Pair⁃wise comparison showed statistical significance(P<0.05).The AUC of serum IL-33 expression in predicting postpartum depression in gestational diabetes mellitus group was 0.896(95%CI:0.776-0.925),when the cut-off value was 211.76 ng/ml,the sensitivity and specificity were 86.56%and 87.24%,respectively.The AUC of serum IL-33 expression in predicting moderate-severe postpartum depression in gestational diabetes mellitus group was 0.812(95%CI:0.698-0.902),when the cut-off value was 231.55 ng/ml,the sensitivity and specificity were 78.98%and 87.13%,respectively.Conclusion The serum expression of IL-33 in gestational diabetes mellitus during the early pregnancy is significantly increased,which can be used as a serological marker to predict the incidence of postpartum depression.