摘要
目的探究妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血清血管生成素样蛋白8(angiopoietin like protein 8,ANGPTL8)、微小RNA(miR)-143-3p水平与不良妊娠结局的关系。方法选取2021年12月至2023年3月山西医科大学第一医院产科收治的104例GDM患者为GDM组,104例健康孕妇作为对照组。检测血脂、血糖等生化指标;酶联免疫吸附和荧光定量PCR法分别检测血清ANGPTL8和miR-143-3p水平。对GDM患者随访至分娩,分为不良妊娠结局组(n=25)及良好妊娠结局组(n=79)。比较对照组和GDM组临床资料及生化指标、血清ANGPTL8、miR-143-3p水平;比较良好妊娠结局组和不良妊娠结局组临床资料及生化指标、血清ANGPTL8、miR-143-3p水平;分析GDM患者血清ANGPTL8、miR-143-3p、临床资料及生化指标的相关性,影响不良妊娠结局发生的因素及GDM患者血清ANGPTL8、miR-143-3p水平对不良妊娠结局的预测价值。结果与对照组比较,GDM组体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、超敏C-反应蛋白(hs-CRP)、胰岛素抵抗指数(HOMA-IR)、ANGPTL8水平显著升高,miR-143-3p水平显著降低(P<0.05)。GDM患者血清ANGPTL8与miR-143-3p水平呈负相关,与BMI、TC、TG、LDL-C、FPG、HbA1c、FINS、hs-CRP、HOMA-IR水平呈正相关(P<0.05);血清miR-143-3p与BMI、TC、TG、LDL-C、FPG、HbA1c、FINS、hs-CRP、HOMA-IR水平呈负相关(P<0.05)。与良好妊娠结局组比较,不良妊娠结局组BMI、TC、TG、LDL-C、FPG、HbA1c、FINS、hs-CRP、HOMA-IR、ANGPTL8水平升高,miR-143-3p水平降低(P<0.05)。TG高水平、FPG高水平、HbA1c高水平、FINS高水平、HOMA-IR高水平、ANGPTL8高水平、miR-143-3p低水平均是影响GDM患者发生不良妊娠结局的独立危险因素(P<0.05)。血清ANGPTL8和miR-143-3p二者联合预测GDM患者不良妊娠结局的曲线下面积显著高于ANGPTL8、miR-143-3p各自单独预测(P<0.05)。结论GDM患者血清ANGPTL8呈高表达,miR-143-3p呈低表达,二者水平与不良妊娠结局密切相关,有望成为预测GDM不良妊娠结局的有效生物标志物。
Objective To explore the relationship between serum angiopoietin like protein 8(ANGPTL8)and microRNA(miR)-143-3p levels and adverse pregnancy outcomes in patients with gestational diabetes mellitus(CDM).Methods A total of 104 CDM patients admitted to the Department of Obstetrics,the First Hospital of Shanxi Medical University from December 2021 to March 2023 were selected as GDM group,and 104 healthy pregnant women were selected as control group.Detected biochemical indicators such as blood lipids and blood sugar.Serum levels of ANGPTL8 and miR-143-3p were detected by enzyme-linked immunosorbent assay and quantitative fluorescence PCR.GDM patients were followed up until delivery and divided into adverse pregnancy outcome group(n=25)and good pregnancy outcome group(n=79).The clinical data,biochemical indexes,serum levels of ANGPTL8 and miR-143-3p were compared between control group and GDM group.The clinical data,biochemical indexes,serum levels of ANGPTL8 and miR-143-3p were compared between good pregnancy outcome group and adverse pregnancy outcome group.The correlation of serum ANGPTL8,miR-143-3p,clinical data and biochemical indexes in GDM patients,factors affecting adverse pregnancy outcomes,the predictive value of serum ANGPTL8 and miR-143-3p levels in CDM patients for adverse pregnancy outcomes were analyzed.Results Compared with control group,body mass index(BMI),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),hypersensitive C-reactive protein(hs-CRP),insulin resistance index(HOMA-IR),ANGPTL8 levels of CDM group were significantly increased,and miR-143-3p level was significantly decreased(P<0.05).Serum ANCPTL8 was negatively correlated with miR-143-3p levels and positively correlated with BMI,TC,TG,LDL-C,FPG,HbAIc,FINS,hs-CRP and HOMA-IR levels in CDM patients(P<0.05);serum miR-143-3p was negatively correlated with BMI,TC,TG,LDL-C,FPG,HbAlc,FINS,hs-CRP and HOMA-IR levels(P<0.05).Compared with good pregnancy outcome group,the levels of BMI,TC,TG,LDL-C,FPG,HbAlc,FINS,hs-CRP,HOMA-IR and ANGPTL8 in the adverse pregnancy outcome group were significantly increased,while the levels of miR-143-3p were significantly decreased(P<0.05).High level of TG,high level of FPG,high level of HbAlc,high level of FINS,high level of HOMA-IR,high level of ANGPTL8 and low level of miR-143-3p were all independent risk factors for adverse pregnancy outcomes in GDM patients(P<0.05).The area under curve predicted adverse pregnancy outcomes in GDM patients by the combination of serum ANCPTL8 and miR-143-3p was significantly higher than that predicted by ANGPTL8 and miR-143-3p alone(P<0.05).Conclusion Serum expression of ANGPTL8 is high and miR-143-3p is low in GDM patients,the levels of both are closely correlated with adverse pregnancy outcomes and are expected to be effective biomarkers for predicting adverse pregnancy outcomes with CDM.
作者
宋娇
王永红
杨海澜
于艳芳
Song Jiao;Wang Yonghong;Yang Haian;Yu Yanfang(Department of Obstetrics,the First Hospital of Shanxi Medical University,Taiyuan Shanxi 030001,P.R.China)
出处
《中国计划生育和妇产科》
2023年第12期73-78,共6页
Chinese Journal of Family Planning & Gynecotokology
基金
山西省卫生健康委科研课题(项目编号:2022049)。