血清基质细胞趋化因子-1α、成纤维细胞生长因子21检测在妊娠期糖尿病产后随访中的价值

Value of stromal cell-derived factor 1α and fibroblast growth factor 21 in postpartum follow-up of puerperae with gestational diabetes mellitus

目的探讨血清基质细胞趋化因子-1α(SDF-1α)及成纤维细胞生长因子21(FGF21)检测在妊娠期糖尿病(GDM)产后随访中的价值。方法于2014年1月至2015年1月选择本院收治的121例GDM患者,依据产后6~8周血糖筛查结果分为DM组25例、糖耐量受损(IGT)组31例及正常糖耐量(NGT)组65例。比较各组患者空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、SDF-1α及FGF21水平的差异。分析血清SDF-1α及FGF21水平与各项临床指标的相关性。结果 (1)产后随访结果显示,DM组患者的FBG、HOMA-IR、TG、SDF-1α及FGF21均明显高于IGT与NGT组,差异均有统计学意义(P<0.05);NGT组患者的FBG、HOMA-IR、TG、SDF-1α及FGF21均明显低于DM组及IGT组,差异均有统计学意义(P<0.05);(2)Pearson相关分析结果显示,血清SDF-1α水平与FBG、HOMA-IR、TG均呈正相关(P<0.05),相关系数r分别为0.272、0.413与0.285;血清FGF21水平与FBG、HOMA-IR、TG均呈正相关(P<0.05),相关系数r值分别为0.291、0.411与0.302。结论血清SDF-1α、FGF21可能是筛查GDM患者产后糖代谢异常的有效指标。

Objective To evaluate the value of stromal cell-derived factor 1α(SDF-1α) and fibroblast growth factor 21(FGF21) in postpartum follow-up of puerperae with gestational diabetes mellitus(GDM). Methods A total of121 patients with GDM from Jan. 2014 to Jan. 2015 in our hospitals were chosen and divided into DM group(n=25), impaired glucose tolerance(IGT) group(n=31) and normal glucose tolerance(NGT) group(n=65) based on blood glucose screening results in postpartum 6~8 weeks. The fasting blood glucose(FBG), HOMA insulin resistance(HOMA-IR), triglyceride(TG), SDF-1α and FGF21 levels were tested and compared between the two groups. The correlation between clinical indexes and serum levels of SDF-1 α and FGF21 were analyzed. Results(1) Postpartum follow-up results showed that FBG, HOMA-IR, TG, SDF-1α and FGF21 in DM group were significantly higher than those in IGT group and NGT group, with statistically significant difference(P<0.05). The FBG, HOMA-IR, TG, SDF-1 α and FGF21 in NGT group were significantly lower than those in DM group and IGT group, with statistically significant difference(P<0.05).(2) Pearson correlation analysis showed that the level of SDF-1α was positively correlated with FBG, HOMA-IR,and TG(r=0.272, r=0.413, r=0.285; P<0.05), and the level of FGF21 was positively correlated with FBG, HOMA-IR,and TG(r=0.291, r=0.411, r=0.302; P<0.05). Conclusion The levels of SDF-1α and FGF21 might be effective indexes for screening postpartum abnormal glucose metabolism in patients with GDM.