摘要
目的 探讨孕早期母体血清白介素(IL)-33、可溶性肿瘤抑制素2(sST2)水平及其比值与妊娠期糖尿病(GDM)的相关性。方法 选择2017年4月至2020年12月期间在赤峰市医院早孕门诊于孕8~12周建档并定期产检的244例孕妇为研究对象;根据孕24~28周时75g口服葡萄糖耐量试验(OGTT)结果将其分为GDM组(n=40)和正常葡萄糖耐量(NGT)组(n=204),比较两组间孕早期(孕8~12周)的临床资料、血清IL-33和sST2水平、IL-33/sST2比值的差异。采用Pearson分析IL-33、sST2水平及其比值与OGTT时空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)的相关性,采用Logistic回归模型分析GDM的影响因素,采用受试者工作特征(ROC)曲线分析孕早期IL-33水平及IL-33/sST2比值对GDM的预测价值。结果 GDM组孕妇的年龄、孕前体质量指数、孕早期增重,以及血红蛋白(Hb)、红细胞计数、白细胞计数、甘油三酯、总胆固醇(TC)、γ-谷氨酰基转移酶、碱性磷酸酶、IL-33、sST2水平均显著高于NGT组,IL-33/sST2比值低于NGT组,差异均有统计学意义(t=2.064~4.829、U=4.582,P<0.05)。GDM组孕早期血清IL-33水平及IL-33/sST2比值与孕中期OGTT时的FPG、HOMA-IR均呈负相关(r分别为-0.434、-0.391、-0.546、-0.534,P<0.001),孕早期血清sST2水平与孕中期OGTT时的FPG、HOMA-IR均呈正相关(r分别为0.373、0.343,P<0.05)。Logistic回归分析显示:IL-33、IL-33/sST2、Hb、TC均是发生GDM的影响因素(Waldχ^(2)值分别为14.551、14.039、5.678、7.072,P<0.05)。ROC曲线分析显示:IL-33、IL-33/sST2单一指标及回归方程联合指标均对GDM具有预测价值,联合指标的预测效能优于单一指标,灵敏度和特异度分别为80.00%和88.73%。结论 GDM孕早期母体血清IL-33水平增加、IL-33/sST2比值降低,推测IL-33代偿性分泌不足与GDM发病有关,联合使用IL-33、IL-33/sST2、Hb、TC具有较好地预测GDM的价值。
Objective To study the correlation between maternal serum interleukin(IL)-33,soluble suppression of tumorigenicity 2(sST2) contents and its ratio in early pregnancy and gestational diabetes mellitus(GDM).Methods A total of 244 pregnant women who visited the early pregnancy clinic of Chifeng Municipal Hospital at 8-12 weeks of gestation from April 2017 to December 2020 and conducted regular obstetric visits were selected as the study subjects.They were divided into the GDM group(n=40) and the normal glucose tolerance(NGT) group(n=204) according to the results of oral glucose tolerance test(OGTT) at 24-28 weeks of gestation.The differences of clinical data, serum IL-33 and sST2 contents and IL-33/sST2 ratio of early pregnancy(8-12 weeks of gestation) between the two groups were compared.The correlation between the serum IL-33,sST2 contents and its ratio and fasting plasma glucose(FPG),homeostatic model assessment for insulin resistance(HOMA-IR) at OGTT were analyzed by Pearson test.The influencing factors of GDM were analyzed by Logistic regression model, and the predictive value of IL-33 level and IL-33/sST2 ratio in early pregnancy on GDM was analyzed by receiver operating characteristic(ROC) curve.Results Age, pre-pregnancy body mass index, weight gain in early pregnancy, hemoglobin(Hb),red blood cell count, white blood cell count, triglyceride, total cholesterol(TC),γ-glutamyltransferase, alkaline phosphatase, IL-33 and sST2 in the GDM group were higher than those in the NGT group, and the ratio of IL-33/sST2 was lower than that in the NGT group(t=2.064-4.829,respectively, U=4.582,P<0.05).In the GDM group, the content of serum IL-33 and the ratio of IL-33/sST2 were negatively correlated with FPG and HOMA-IR at OGTT during the second trimester of pregnancy(r=-0.434,-0.391,-0.546 and-0.534,respectively, P<0.001),and the content of sST2 of early pregnancy was positively correlated with FPG and HOMA-IR at OGTT during the second trimester of pregnancy(r=0.373 and 0.343,respectively, P<0.05).Logistic regression anal
作者
李秀娟
张林林
于志娟
LI Xiujuan;ZHANG Linlin;YU Zhijuan(Department of Obstetrics,Chifeng Municipal Hospital,Inner Mongolia Chi feng 024000,China;Department of Obstetrics,Ar Horqin Banner Maternal and Child Health Family Planning Service Center,Inner Mongolia Chi feng 025550,China)
出处
《中国妇幼健康研究》
2022年第9期57-63,共7页
Chinese Journal of Woman and Child Health Research
基金
赤峰市自然科学科研项目(SZR21206)。
关键词
妊娠期糖尿病
白介素-33
可溶性肿瘤抑制素2
预测
gestational diabetes mellitus
interleukin-33
soluble suppression of tumorigenicity 2
prediction
