血清Cys-c、NLR、TFF3对妊娠期糖尿病早期肾功能损伤的预测价值

Prognostic value of serum Cys-c,NLR and TFF3 for early renal function impairment in gestational diabetes mellitus

目的探讨血清中胱抑素-C(Cys-c)、中性粒细胞与淋巴细胞比值(NLR)、三叶因子3(TFF3)在妊娠期糖尿病(GDM)患者中的表达情况以及对GDM患者早期肾损伤的预测价值。方法选取2021年1月至2023年1月就诊于西北妇女儿童医院的105例GDM患者为观察组,选择同期就诊的62名健康孕妇作为对照组。观察组根据有无肾功能损伤分为肾功能正常组58例,肾功能损伤组47例;根据糖化血红蛋白(HbA1c)水平分为<5.5%21例,HbA1c 5.5%~6.5%36例,HbA1c>6.5%48例。收集所有观察对象一般资料,比较观察组与对照组Cys-c、NLR、TFF3水平差异。比较观察组HbA1c(<5.5%,5.5%~6.5%,>6.5%)三组间Cys-c、NLR、TFF3水平差异。比较观察组肾功能正常组与肾功能损伤组Cys-c、NLR、TFF3水平差异。采用受试者工作特征曲线(ROC)分析Cys-c、NLR、TFF3对早期肾功能损害的预测价值。结果观察组血清Cys-c、NLR、TFF3水平高于对照组,差异有统计学意义(t=8.45,8.27,8.99,P<0.05)。血清Cys-c、NLR、TFF3水平:HbA1c>6.5%组>HbA1c5.5%~6.5%组>HbA1c<5.5%组,差异有统计学意义(F=20.993,45.293,55.855,P<0.05)。肾功能损伤组血清Cys-c、NLR、TFF3水平高于肾功能正常组,差异有统计学意义(t=6.02,9.20,7.07,P<0.05)。ROC结果显示,Cys-c、NLR、TFF3及联合检测的AUC分别为0.859,0.857,0.864,0.873。结论血清Cys-c、NLR、TFF3均在GDM患者中显著升高,三者联合检测对GDM患者早期肾损伤预测有一定价值,可能为GDM患者早期肾损伤的预测提供新的途径与方法。

Objective To investigate the expression of serum cystatin C(Cys-c),neutrophil to lymphocyte ratio(NLR),and trefoil factor 3(TFF3)in patients with gestational diabetes(GDM),and to predict the early renal injury in GDM patients.Methods 105 GDM patients who visited Hospital in Northwest Women's and Children's from January 2021 to January 2023 were selected as the observation group,and 62 healthy pregnant women who visited the same period were selected as the control group.The observation group was divided into a normal renal function group of 58 cases and a renal function injury group of 47 cases based on the presence or absence of renal function injury.According to the level of glycosylated hemoglobin(HbA1c),21 cases were classified as<5.5%,36 cases as HbA1c 5.5%~6.5%,and 48 cases as HbA1c>6.5%.The general data of all observation subjects and the differences in Cys-c,NLR,and TFF3 levels between the observation group and the control group were compared.The differences in Cys-c,NLR,and TFF3 levels among the three groups in the observation group HbA1c(<5.5%,5.5%~6.5%,>6.5%)were compared.The differences in Cys-c,NLR,and TFF3 levels between the normal renal function group and the renal function injury group in the observation group were compared.The predictive value of Cys-c,NLR,and TFF3 in early renal function impairment was analyzed using the receiver operating characteristic curve(ROC).Results The serum levels of Cys-c,NLR,and TFF3 in the observation group were higher than those in the control group,with statistically signifi-cant differences(t=8.45,8.27,8.99,P<0.05).Serum Cys-c,NLR,and TFF3 levels:HbA1c>6.5%group>HbA1c 5.5%~6.5%group>HbA1c<5.5%group,with statistically significant differences(F=20.993,45.293,55.855,P<0.05).The serum levels of Cys-c,NLR,and TFF3 in the group with renal dysfunction were higher than those in the group with normal renal function,and the difference was statistically significant(t=6.02,9.20,7.07,P<0.05).The ROC results showed that the AUC for Cys-c,NLR,TFF3,and combined detection were 0.859,0.857,0.864,and 0.873,respectively.Conclusion Serum Cys-c,NLR and TFF3 are significantly increased in GDM patients,and the combined detection of the three has a certain value in the prediction of early renal injury in GDM and may provide a new way and method for the prediction of early renal injury in GDM.