摘要
目的探讨血清25-羟维生素D[25-hydroxyvitamin D,25(OH)D]和白细胞介素6(interleukin-6,IL-6)水平在妊娠期糖尿病(gestational diabetes mellitus,GDM)孕早期发生骨质疏松症(osteoporosis,OP)中的预测价值。方法选择2018年9月至2022年5月山西省儿童医院收治的GDM的178例孕妇患者作为研究对象,按照骨密度将患者分为OP组和无OP组。收集患者一般资料并进行骨代谢相关生化指标检测,包括钙(calcium,Ca)、磷(phosphorus,P)、β-胶原特殊序列(βcollagen special sequence,β-CTX)、I型胶原氨基前端肽(type I procollagen amino-terminal peptide,PINP)、N端骨钙素(n-telocalcin,N-MID)、骨钙素(osteocalcin,OC)、骨碱性磷酸酶(bone alkaline phosphatase,BAP)。检测两组血清中的25(OH)D和IL-6水平。分析25(OH)D和IL-6水平对GDM合并OP的预测价值。结果与无OP组(29.95±6.88)比较,OP组血清中25(OH)D水平(20.78±6.02)显著降低(t=5.56,P<0.001),OP组IL-6水平(75.19±9.15)明显高于无OP组(50.23±10.08,t=10.26,P<0.001)。两组受试者血清中的Ca、P水平指标和骨代谢指标β-CTX、PINP、N-MID差异无统计学意义(均P>0.05)。OP组BAP(13.25±3.12)和OC(6.62±1.24)水平明显低于非OP组(BAP:18.23±3.78,t=5.52,P<0.001)(OC:8.75±1.52,t=5.87,P<0.001)。Pearson相关分析显示,25(OH)D水平与骨密度、BAP、OC呈正相关(r=0.26、0.21、0.23,均P<0.05)。IL-6水平与骨密度、BAP、OC呈负相关(r=-0.39、-0.21、-0.27,均P<0.05)。ROC曲线分析显示,血清25(OH)D及IL-6能作为GDM孕早期合并OP的有效诊断分子(AUC=0.853,P<0.0001)(AUC=0.869,P<0.0001)。结论GDM孕早期合并OP患者血清中25(OH)D水平降低,IL-6水平增高。血清25(OH)D水平及IL-6水平对GDM孕早期合并OP发病有预测意义。
Objective To explore the predictive value of serum 25-hydroxyvitamin D[25(OH)D]and interleukin-6(IL-6)levels in the development of osteoporosis(OP)in gestational diabetes mellitus(GDM)during early pregnancy.Methods A total of 178 pregnant women with GDM admitted to Shanxi Provincial Children’s Hospital from Sep.2018 to May.2022 were selected as the research subjects and divided into OP group and non-OP group based on bone density.General information of patients was collected,and biochemical indicators related to bone metabolism were measured,including calcium(Ca),β-collagen special sequence(β-CTX),type 1 procollagen amino-terminal peptide(PINP),n-terminal bone calciuim(N-MID),osteocalcin(OC),and bone alkaline phosphatase(BAP).The levels of 25(OH)D and IL-6 in the serum of the two groups were measured.The predictive value of 25(OH)D and IL-6 levels for GDM complicated with OP was analyzed.Results Compared with the non-OP group(29.95±6.88),the serum 25(OH)D level was significantly lower in the OP group(20.78±6.02)(t=5.56,P<0.001),and the IL-6 level was significantly higher in the OP group(75.19±9.15)than in the non-OP group(50.23±10.08)(t=10.26,P<0.001).There was no significant difference in the levels of Ca,P,β-CTX,PINP,or N-MID between the two groups(all P>0.05).The levels of BAP(13.25±3.12)and OC(6.62±1.24)in the OP group were significantly lower than those in the non-OP group(BAP:18.23±3.78,t=5.52,P<0.001;OC:8.75±1.52,t=5.87,P<0.001).Pearson correlation analysis showed a positive correlation between 25(OH)D level and bone density,BAP,and OC(r=0.26,0.21,0.23,all P<0.05),while IL-6 level showed a negative correlation with bone density,BAP,and OC(r=-0.39,-0.21,-0.27,all P<0.05).ROC curve analysis showed that serum 25(OH)D and IL-6 could serve as effective diagnostic markers for GDM complicated with OP(AUC=0.853,P<0.0001;AUC=0.869,P<0.0001)during early pregnancy.Conclusions The serum 25(OH)D level is decreased and IL-6 level is increased in GDM patients with OP during early pregnancy.The levels of serum 25(OH)D and IL-6 have predictive value for the development of GDM complicated with OP during early pregnancy.
作者
朱改变
贺素娟
张秋妍
刘宾宾
刘飞飞
Zhu Gaibian;He Sujuan;Zhang Qiuyan;Liu Binbin;Liu Feifei(Department of Obstetrics and Gynecology,Shanxi Provincial Children’s Hospital,Taiyuan 030006,China;Obstetrical department,Shanxi Provincial Children’s Hospital,Taiyuan 030006,China;Department of Orthopedics,Shanxi Provincial Children’s Hospital,Taiyuan 030006,China)
出处
《中华内分泌外科杂志》
CAS
2023年第5期559-563,共5页
Chinese Journal of Endocrine Surgery
基金
山西省基础研究计划项目(202103021224435)。