妊娠糖尿病患者血清LRG1和CCL2水平对产后血糖转归的预测价值

Predictive value of serum LRG1 and CCL2 levels in pregnant women with diabetes mellitus on the prognosis of postpartum blood glucose

目的 观察血清富亮氨酸α2-糖蛋白(LRG1)和CC趋化因子配体2(CCL2)水平对妊娠糖尿病(GDM)患者产后血糖转归的预测价值。方法 回顾性选取2020年1月至2023年6月邯郸市第一医院收治的110例GDM患者作为研究对象,根据产后6周血糖转归情况将患者分为正常组(n=65)与异常组(n=45)。比较两组患者孕晚期及产后的糖脂代谢指标[糖化血红蛋白(GHb)、空腹血糖、餐后2 h血糖(2 hPG)、胰岛素抵抗指数(HOMA-IR)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]和血清LRG1、CCL2水平。采用多因素Logistic回归分析对患者产后血糖转归的影响因素进行分析,应用受试者工作特征(ROC)曲线评估LRG1、CCL2水平及两者联合对GDM患者产后血糖转归的预测价值。结果 两组患者孕晚期及产后的GHb、总胆固醇、HDL-C、LDL-C水平比较,差异均无统计学意义(P>0.05);正常组患者孕晚期及产后的空腹血糖、2 hPG、HOMA-IR、甘油三酯水平均低于异常组,差异均有统计学意义(P<0.05)。正常组孕晚期及产后的LRG1、CCL2水平均低于异常组,差异均有统计学意义(P<0.05)。多因素Logistci回归分析显示,空腹血糖、HOMA-IR、LRG1、CCL2与GDM患者产后血糖转归密切相关(P<0.05)。血清LRG1、CCL2水平联合检测对GDM患者产后血糖转归预测的曲线下面积为0.879。结论 GDM患者产后血糖正常者的孕晚期及产后的血清LRG1、CCL2水平均明显低于异常者。LRG1、CCL2联合检测能够有效预测GDM患者产后血糖转归情况。

Objective To observe the predictive value of the levels of serum rich leucineα2-glycoprotein(LRG1)and C-C motif chemokine ligand 2(CCL2)on the postpartum blood glucose outcome in patients with gestational diabetes mellitus(GDM).Methods A retrospective study was conducted on 110 GDM patients admitted to Handan First Hospital from January 2020 to June 2023.Patients were divided into the normal group(n=65)and the abnormal group(n=45)based on their blood glucose outcomes at 6 weeks postpartum.The glucose and lipid metabolism indicators[glycosylated hemoglobin(GHb),fasting blood glucose,2-hour postprandial blood glucose(2 hPG),insulin resistance index(HOMA-IR),total cholesterol,triglycerides,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)],and serum LRG1 and CCL2 levels between the two groups of patients during late pregnancy and postpartum period were compared.The influencing factors of postpartum blood glucose outcome in patients were analyzed using multivariate Logistic regression analysis.The predictive value of LRG1,CCL2 levels,and their combination on postpartum blood glucose outcomes in GDM patients were evaluated using receiver operating characteristic(ROC)curves.Results There were no statistically significant differences between the two groups of patients in the levels of GHb,total cholesterol,HDL-C,and LDL-C between the two groups of patients during late pregnancy and postpartum period(P>0.05);the levels of triglycerides,fasting blood glucose,2 hPG,and HOMA-IR in the late pregnancy and postpartum period of the normal group were significantly lower than those in the abnormal group,the differences were statistically significant(P<0.05).And the levels of serum LRG1 and CCL2 of the normal group were significantly lower than those in the abnormal group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that fasting blood glucose,HOMA-IR,LRG1,CCL2 were closely related to postpartum blood glucose outcomes in GDM patients(P<0.05).The combined detection of serum LRG1 and CCL2 levels for predicting postpartum blood glucose outcomes in GDM patients has an area under the curve of 0.879.Conclusion The serum LRG1 and CCL2 levels in GDM patients with normal postpartum blood sugar were significantly lower in the late pregnancy and postpartum period compared to those with abnormal blood glucose levels.The combined detection of LRG1 and CCL2 can effectively predict the postpartum blood glucose outcome in GDM patients.