妊娠糖尿病患者负性情绪及危险因素分析

目的调查妊娠糖尿病(GDM)患者负性情况的发生状况,并分析其危险因素。方法选取2014年6月—2016年6月海南省人民医内分泌科就诊的GDM患者189例,根据医院用焦虑抑郁量表(HADS)评分结果,分为GDM合并负性情绪组(GDM+负性情绪组,HADS>15分)Ⅲ例和GDM不合并负性情绪组(GDM组,HADS≤15分)88例。另根据HADS评分将GDM+负性情绪组分为轻度负性情绪亚组(16≤HADS≤20)39例、中度负性情绪亚组(21≤HADS≤30)37例及重度负性情绪亚组(31≤HADS≤42)35例。采用Pearson相关分析HADS评分水平的相关因素。采用Logistic回归分析GDM患者合并负性情绪的影响因素。结果 (1) GDM患者合并负性情绪的发生率为58.73%(111/189)。GDM+负性情绪组孕前BMI、FPG、HbA1c、TC、TG、HDL-C、HOMA-IR及糖尿病家族史患者比例均高于GDM组(P <0.05);(2)重度负性情绪亚组FPG、Hb A1c、TC、TG、HDL-C及HOMA-IR水平均高于轻度负性情绪亚组和中度负性情绪亚组,且中度负性情绪亚组FPG、Hb A1c、TC及HOMA-IR水平高于轻度负性亚组(P <0.05);(3) Pearson相关分析显示,孕前BMI、孕期体重增加、FPG、HbA1c、TC、TG、HDL-C、HOMA-IR及有糖尿病家族史均与HADS评分相关(P<0.05);(4)孕前BMI、孕期体重增加、HbA1c及糖尿病家族史是GDM合并负性情绪的危险因素(P<0.01)。结论 GDM患者合并负性情绪的发生率仍较高,尤其是孕前BMI高、孕期体重增加、HbA1c水平高及有糖尿病家族史的患者。因此,对该类孕妇应及早的进行心理干预,提供更多的心理辅导,预防负性情绪的发生。

Significance of highly phosphorylated insulin-like growth factor binding protein-1 and cervical length for prediction of preterm delivery in twin pregnancies

BACKGROUND A twin pregnancy can carry greater risks than singleton pregnancies.About 60 in 100 twin pregnancies result in spontaneous birth before 37 wk,which is associated with several complications in the premature babies.Clinical detection of biomarkers may help to predict the possibility of premature birth so that corresponding interventions can be given to the pregnant women in a timely manner,in order to reduce the risk of preterm birth and improve the outcomes of the newborn infants.AIM To explore the clinical value of transvaginal ultrasound measurement of cervical length combined with insulin-like growth factor binding protein-1(IGFBP-1)hyperphosphorylation in cervical secretions as predictors of preterm delivery in twin pregnancies.METHODS A total of 254 pregnant women with twin pregnancies,who were admitted to Hainan General Hospital and underwent maternity examination,were selected as the study subjects from January 2015 to December 2018.All participants received transvaginal ultrasound measurement of cervical length and phosphorylated IGFBP-1(phIGFBP-1)test between 24 and 34 wk gestation.The pregnancy outcomes were analyzed.RESULTS Of the women with a positive phIGFBP-1 test result,preterm birth rate was higher in those with a cervical length≤25 mm than those with a cervical length>25 mm(all P<0.05).Similarly,in women with a negative phIGFBP-1 test result,preterm birth rate was higher in those with a cervical length≤25 mm than those with a cervical length>25 mm(all P<0.05).The sensitivity,specificity,and positive and negative predictive values of the phIGFBP-1 test combined with the cervical length test were 95.71%,91.21%,95.12%and 92.22%,respectively,for the prediction of preterm birth.CONCLUSION Cervical length combined with phIGFBP-1 tests is of value for the prediction of outcomes of preterm delivery in twin pregnancies.

Clinical significance of lncRNA LINC01410 in preeclampsia and its effect on trophoblast proliferation and invasion

Objective:To study the expression of lncRNA LINC01410 in preeclampsia and normal placenta,and to explore its function and mechanism of affecting the proliferation and migration of trophoblast cells.Methods:The expression level of LINC01410 in the placenta of preeclampsia patients and pregnant women with normal pregnancy was detected by qRTPCR.After silencing LINC01410 in trophoblast cells HTR-8/Svneo,CCK-8 measured cell proliferation,and Transwell detected trophoblast invasion.Nucleus and chromatin RNA scores were measured,and Fas was detected by qRT-PCR and Western blot to explore the possible mechanisms.Results:The relative expression of LINC01410 in the placenta of the preeclampsia group was 2.564±0.169,which was significantly higher than 0.821±0.052 in the placenta tissue of the normal control group.After silencing LINC01410,the proliferation of trophoblast HTR-8/Svneo slowed down and the invasion ability decreased;The expression in the nucleus is more than in the cytoplasm,and the expression of Fas mRNA and protein is significantly reduced after silencing LINC01410.Conclusion:The high expression of lncRNA LINC01410 in preeclampsia placenta may be a risk factor for preeclampsia,and its mechanism may be to promote the proliferation and invasion of trophoblast cells by upregulating Fas expression.

Effect of interaction between long non-coding RNA malat1 and microrna-146a on trophoblast function in preeclampsia

Objective:To explore the interaction of long noncoding RNA (LncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) with microRNA (miRNA)-146a on the effect and mechanism of preeclampsia (PE) trophoblast function.Methods: Choriocarcinoma cell line JEG-3 were cultured in vitro, and JEG-3 cells were transfected into four groups, namely Control, sh-MALAT1, miR-146a-5p inhibitor and sh-MALATI+miR-146a-5p inhibitor group. The sh-MALAT1 group was transfected with sh-MALAT1, the miR-146a-5p inhibitor group was transfected with miR-146a-5p inhibitor, the sh-MALAT1+inhibitor group was co-transfected with sh-MALAT1 and miR-146a-5p inhibitor, and Isometric empty vector was added in to the Control group. The mRNA level was detected by qPCR;the target relationship between MALAT1 and miR-146a-5p was predicted by bioinformation;the proliferation ability of JEG-3 cells was detected by CCK8 experiment after the four groups of plasmids were transfected;Western blot was used to detect the expression of protein in JEG-3 cells after different treatments.Results: sh-MALATl significantly decreased sh-MALATl and increased the mRNA level of miR-146a-5p in the choriocarcinoma cell line JEG-3. sh-MALATl inhibited the proliferation of JEG-3 cells, miR-146a-5p inhibitor promoted the proliferation of JEG-3 cells and weakened the effect of sh-MALATl production. At the same time, sh-MALATl attenuates the expression of TRAF6, VEGR, and MMP2 proteins in trophoblast cells, while miR-146a-5p inhibitor can enhance its expression and reduce the inhibitory effect of sh-MALATl.Conclusion: MALATl and miR-146a can interact to affect the biological behavior of trophoblast cells in preeclampsia.