妊娠前三酰甘油/高密度脂蛋白胆固醇值联合胱抑素C预测妊娠期糖尿病的价值

Predictive value of pregestational TG/HDL-C ratio combined with cystatin C in predicting gestational diabetes in pregnant women

目的分析妊娠前妇女血清三酰甘油/高密度脂蛋白胆固醇值(TG/HDL-C)、胱抑素C(Cys-C)水平及其与胰岛素抵抗的关系,探讨TG/HDL-C及胱抑素C水平与妊娠期糖尿病(GDM)的相关性。方法选取2020年1月—2022年6月在皖西卫生职业学院附属医院就诊的孕产妇198例为研究对象,按照是否发生GDM分为观察组(发生GDM)98例与对照组(未发生GDM)100例。收集2组研究对象的一般临床资料,并分析其与GDM的关系。结果2组妇女学历、家庭经济、饮食控制、运动量、吸烟史、饮酒史、腰围、SBP、DBP、空腹血糖(FPG)、ALT、AST、肌酐(Cr)、尿酸(UA)、TC、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)差异均无统计学意义(P>0.05),而年龄、BMI、Cys-C、TG、TG/HDL-C值差异均有统计学意义(P<0.05);Logistic回归分析显示,高年龄、高水平的血清Cys-C及高水平的TG/HDL-C值均为GDM发生的独立危险因素(P<0.05),OR值分别为1.111、3.190和3.970。ROC曲线分析结果显示TG/HDL-C值和Cys-C曲线下面积(AUC)分别为0.820(P<0.001)和0.667(P<0.001);两者联合检测的AUC值为0.848(P<0.001),诊断效能优于单项检测。结论妊娠前血清TG/HDL-C值和Cys-C水平高的女性更容易发生GDM,该两项指标有望用于备孕期女性发生GDM的风险评估和预测。

Objective This study aims to examine the association between the triglycerides to HDL cholesterol(TG/HDL-C),cystatin C levels,and insulin resistance in pre-pregnancy women.Additionally,it seeks to investigate the correlation between TG/HDL-C and cystatin C with gestational diabetes mellitus(GDM).Methods A total of 198 pregnant women at the Affiliated Hospital of West Anhui Health Vocational College from January 2020 to June 2022 were selected as the research objects.They were divided into two groups:the observation group(98 cases with GDM)and the control group(100 cases without GDM).General clinical data from both groups were collected and analyzed to explore the relationship between these data and GDM.Results There were no significant difference in education,family economic situation,diet control,exercise,smoking history,drinking history,waist circumference,SBP,DBP,FPG,ALT,AST,Cr,UA,TC,HDL-C,and LDL-C between the two groups(P>0.05).However,but there were significant difference in age,BMI,Cys-C,and LDL-C.Logistic regression analysis showed that advanced age,elevated serum Cys-C,and increased TG/HDL-C ratio were independent risk factors for GDM(P<0.05),with corresponding OR of 1.111,3.190 and 3.970 respectively.ROC curve analysis demonstrated that TG/HDL-C ratio had an area under the Cys-C curve(AUC)of 0.820(P<0.001),while Cys-C had an AUC of 0.667(P<0.001).The combined detection of both parameters yielded an AUC of 0.848(P<0.001),indicating better diagnostic efficiency compared to individual tests.Conclusion Pregnant women with high serum TG/HDL-C ratio and Cys-C levels prior to pregnancy are at a higher risk of GDM.These two indicators hold promise for risk assessment and prediction of GDM in pregnant women.