GDM合并HBV感染患者血清HBV-DNA载量与糖脂代谢和不良妊娠结局的关系

Relationship between serum HBV-DNA load,glucose and lipid metabolism and adverse pregnancy outcomes in patients with GDM combined with HBV infection

目的探究妊娠期糖尿病(GDM)合并乙型肝炎病毒(HBV)感染患者血清HBV脱氧核糖核酸(HBV-DNA)载量与糖脂代谢和不良妊娠结局的关系。方法选择2019年12月-2021年12月在周口市妇幼保健院进行分娩的120例GDM产妇,根据HBV感染状态将其分为HBV有症状感染组(n=40)、HBV无症状感染组(n=40)与单纯GDM组(n=40),同时选择同期健康产妇40名为健康组作为对照。比较HBV有症状感染组、HBV无症状感染组的血清HBV-DNA载量,比较4组产妇空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、瘦素(LP)、脂联素(ADPN)水平及不良妊娠结局,并分析GDM合并HBV感染患者血清HBV-DNA载量与糖脂代谢和不良妊娠结局的关系。结果HBV有症状感染组HBV-DNA载量为(8.86±1.57)lg拷贝/mL,高于HBV无症状感染组的(7.19±1.32)lg拷贝/mL,差异有统计学意义(t=6.992,P<0.05)。随着HBV感染逐渐加重,FPG、HbA1c、TG、TC、LP水平随之升高,ADPN水平随之降低,健康组、单纯GDM组、HBV无症状感染组、HBV有症状感染组间比较差异均有统计学意义(F=80.802、56.430、4.882、23.987、49.074、24.452,P均<0.05)。健康组、单纯GDM组、HBV无症状感染组、HBV有症状感染组不良妊娠结局总发生率分别为2.50%、20.00%、32.50%、42.50%,差异有统计学意义(χ^(2)=22.072,P<0.05)。Pearson相关分析结果显示,GDM合并HBV感染患者血清HBV-DNA载量与LP成正相关,与ADPN成负相关,差异有统计学意义(r=0.325、-0.259,P均<0.05)。结论GDM合并HBV感染患者血清HBV-DNA载量会随着HBV感染加重而升高,血清HBV-DNA载量与LP成正相关,与ADPN成负相关。

Objective To investigate the Relationship between serum HBV-DNA load,glucose and lipid metabolism and adverse pregnancy outcomes in patients with gestational diabetes mellitus(GDM)combined with hepatitis B virus(HBV)infection.Methods A total of 120 pregnant women with GDM who gave birth in the Zhoukou Maternal and Child Health Hospital between December 2019 and December 2021 were selected.According to the presence or absence of HBV infection,the subjects were divided into symptomatic HBV infection group(n=40),asymptomatic HBV infection group(n=40)and simple GDM group(n=40).Meanwhile,40 healthy pregnant women were selected as the health group.Serum HBV-DNA load was compared between the symptomatic HBV infection group and the asymptomatic HBV infection group.Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),leptin(LP)and adiponectin(ADPN) levels,and adverse pregnancy outcomes of the four groups were comparatively analyzed.The relationship of serum HBV-DNA load with glucose and lipid metabolism and adverse pregnancy outcomes in patients with GDM and HBV infection was analyzed.Results The HBV-DNA load of the symptomatic HBV infection group[(8.86±1.5)lg copy/mL]was significantly higher than that of the asymptomatic HBV infection group[(7.19±1.32)lg copy/mL],the difference was statistically significant(t=6.992,P<0.05).With the aggravation of HBV infection,the levels of FPG,HbA1c,TG,TC and LP increased,and the level of ADPN decreased;there were significant differences among health group,simple GDM group,asymptomatic HBV infection group and symptomatic HBV infection group(F=80.802,56.430,4.882,23.987,49.074,24.452;all P<0.05).The total incidence rates of adverse pregnancy outcomes in the health group,simple GDM group,asymptomatic HBV infection group,symptomatic HBV infection group were 2.50%,20.00%,32.50%and 42.50%,respectively,the difference was statistically significant(χ^(2)=22.072,P<0.05).Pearson correlation analysis showed that serum HBV-DNA load of patients with GDM and HBV infection was positively correlated with LP and negatively correlated with ADPN(r=0.325,-0.259,both P<0.05).Conclusions Serum HBV-DNA load of patients with GDM and HBV infection increased with the aggravation of HBV infection.Serum HBV-DNA load was positively correlated with LP and negatively correlated with ADPN.