血清SHBG及TXNIP表达与妊娠期糖尿病胰岛素抵抗及糖脂代谢的相关性研究

Study on the correlation of the expression of serum SHBG and TXNIP with insulin resistance,and glucose and lipid metabolism in gestational diabetes mellitus

目的探究血清性激素结合球蛋白(sex hormone-binding globulin,SHBG)及硫氧还蛋白相互作用蛋白(thioredoxin interacting protein,TXNIP)表达与妊娠期糖尿病(gestational diabetes mellitus,GDM)胰岛素抵抗及糖脂代谢的相关性。方法选取西北妇女儿童医院2021年1月—2023年1月收治的GDM患者112例作为研究对象,另选取本院同期孕检的无GDM的妊娠期女性112例作为对照组,比较2组的空腹血糖、餐后2 h血糖、胰岛素抵抗指数、三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)、血清SHBG及TXNIP水平。分析血清SHBG及TXNIP表达与空腹血糖、餐后2 h血糖、糖化血红蛋白、TG、TC、LDL-C、空腹胰岛素及胰岛素抵抗指数的相关性。分析血清SHBG及TXNIP对GDM发病的评估价值。结果研究组空腹血糖、餐后2 h血糖、糖化血红蛋白、TG、TC、LDL-C、空腹胰岛素及胰岛素抵抗指数均高于对照组(P<0.05)。研究组SHBG低于对照组,TXNIP高于对照组(P<0.05)。血清SHBG与空腹血糖、餐后2 h血糖、糖化血红蛋白、TG、TC、LDL-C、空腹胰岛素及胰岛素抵抗指数呈负相关(P<0.05);血清TXNIP与空腹血糖、餐后2 h血糖、糖化血红蛋白、TG、TC、LDL-C、空腹胰岛素及胰岛素抵抗指数呈正相关(P<0.05)。胰岛素抵抗指数、糖化血红蛋白、血清TXNIP是GDM发病的危险因素(P<0.05),血清SHBG是GDM发病的保护因素(P<0.05)。血清SHBG、TXNIP单一及联合评估GDM发病的曲线下面积(area under the curve,AUC)分别为0.771、0.751、0.844。结论空腹血糖、餐后2 h血糖、糖化血红蛋白、TG、TC、LDL-C、空腹胰岛素及胰岛素抵抗指数与血清SHBG呈负相关,与血清TXNIP呈正相关。

Objective To explore the correlation of the expression of serum sex hormone-binding globulin(SHBG)and thioredoxin interacting protein(TXNIP)with insulin resistance,and glucose and lipid metabolism in gestational diabetes mellitus(GDM).Methods In total,112 GDM patients admitted to the Northwest Women's and Children's Hospital between January 2021 and January 2023 were selected as the research subjects,and another 112 pregnant women without GDM undergoing pregnancy examination in our hospital during the same period were selected as the control group.The levels of fasting blood glucose(FBG),2-hour postprandial glucose(2 hPG),insulin resistance index(IRI),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),serum SHBG and TXNIP were compared between the two groups.The correlation of the expression of serum SHBG and TXNIP with FBG,2 hPG,glycated hemoglobin,TG,TC,LDL-C,fasting insulin and IRI was analyzedas well as the evaluation value of serum SHBG and TXNIP in the pathogenesis of GDM.Results The FBG,2 hPG,glycated hemoglobin,TG,TC,LDL-C,fasting insulin and IRI in the research group were higher than those in the control group(P<0.05).The SHBG of the research group was lower than that of the control group,while TXNIP was higher than that of the control group(P<0.05).Serum SHBG was negatively correlated with FBG,2 hPG,glycated hemoglobin,TG,TC,LDL-C,fasting insulin and IRI(P<05).Serum TXNIP was positively correlated with FBG,2 hPG,glycated hemoglobin,TG,TC,LDL-C,fasting insulin and IRI(P<05).IRI,glycated hemoglobin and serum TXNIP were identified as risk factors for the development of GDM(P<05),while serum SHBG was protective factor for GDM(P<05).The area under the curve(AUC)of serum SHBG and TXNIP alone and in combination in the assessment of development of GDM was 0.771,0.751,and 0.844,respectively.Conclusion FBG,2 h PG,glycated hemoglobin,TG,TC,LDL-C,fasting insulin and IRI are negatively correlated with serum SHBG and positively correlated with serum TXNIP.