摘要
目的探讨高龄妊娠期糖尿病(gestational diabetes mellitus,GDM)患者微小核糖核酸(micro RNA,mi R)-351,纤维细胞生长因子19(fibroblast growth factor 19,FGF19),脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,LP-PLA2)表达及与产后糖代谢异常的相关性。方法选取2019年1月~2022年1月唐山市妇幼保健院高龄GDM患者86例为观察组,同期选取产检的正常高龄孕妇52例为对照组。比较两组血清mi R-351,FGF19和LP-PLA2表达,分析高龄GDM患者mi R-351,FGF19和LP-PLA2与产后糖脂代谢指标相关性,Logistic回归分析高龄GDM患者产后糖代谢异常影响因素,受试者工作特征(ROC)分析mi R-351,FGF19和LP-PLA2对产后糖代谢异常预测价值。结果观察组血清空腹血糖(FPG)(5.93±0.61mmol/L),空腹胰岛素(FINS)(15.82±4.19m U/L),胰岛素抵抗指数(MOHA-IR)(4.31±0.64),三酰甘油(TG)(1.46±0.28mmol/L),低密度酯蛋白-胆固醇(LDL-C)(2.93±0.66mmol/L),mi R-351(6.42±1.76),LP-PLA2活性(33.09±6.51nmol/min·ml)高于对照组(4.48±0.76mmol/L,11.65±3.90m/U/L,2.45±0.57,1.32±0.24mmol/L,2.58±0.59mmol/L,3.79±1.14,24.52±5.83nmol/min·ml),而FGF19(91.18±8.64ng/L)水平低于对照组(122.63±10.29ng/L),差异均有统计学意义(t=2.999~17.226,均P<0.05);高龄GDM患者血清mi R-351水平、LP-PLA2活性与空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(insulin resistance index,HOMA-IR)、三酰甘油(triglyceride,TG)和低密度脂蛋白-胆固醇(low density lipoprotein,LDL-C)呈正相关(r=0.408~0.584,均P<0.05),血清FGF19水平与FPG,FINS和HOMA-IR呈负相关(r=-0.614~-0.386,均P<0.05);高龄GDM患者mi R-351与FGF19呈负相关(r=-0.531,P<0.001),与LPPLA2呈正相关(r=0.549,P<0.001),FGF19与LP-PLA2呈负相关(r=-0.614,P<0.001)。Logistic回归模型分析显示,mi R-351,LP-PLA2活性升高及FGF19降低均为高龄GDM患者产后糖代谢异常独立危险因素(P<0.05);ROC曲线显示,mi R-351,LP-PLA2和FGF19对GDM患者产后糖代谢
Objective To investigate the microRNA(miR)-351,fibroblast growth factor 19(FGF19)and lipoprotein-associated phospholipase A2(LP-PLA2)in elderly patients with gestational diabetes mellitus(GDM)expression and its correlation with abnormal postpartum glucose metabolism.Methods From January 2019 to January 2022,86 elderly patients with GDM in Tangshan Maternal and Child Health Hospital were selected as the observation group,and 52 normal elderly pregnant women who underwent obstetric examination in the hospital during the same period were selected as the control group.The clinical characteristics and serum miR-351,FGF19 and LP-PLA2 expressions were compared between the two groups.The correlation between miR-351,FGF19,LP-PLA2 and postpartum glucose and lipid metabolism indexes in elderly GDM patients was analyzed.Logistic regression was used to analyze postpartum glucose metabolism abnormalities in elderly GDM patients.Influencing factors,receiver operating characteristic(ROC)analysis of the predictive value of miR-351,FGF19 and LP-PLA2 for abnormal postpartum glucose metabolism.Results Fasting plasma glucose(FPG)of observation group(5.93±0.61mmo/L vs 4.48±0.76mmol/L),fasting insulin(FINS)(15.8±4.19mU/L vs 11.65±3.90m/U/L),insulin resistance index(HOMA-IR)(4.31±0.64 vs 2.45±0.57),triglyceride(TG)(1.46±0.28mmol/L vs 1.32±0.24mmol/L),low density lipoprotein-C(LDL-C)(2.93±0.66mmol/L vs 2.58±0.59mmol/L),serum miR-351(6.42±1.76 vs 3.79±1.14),LP-PLA2 activity(33.09±6.51nmol/min·ml vs 24.52±5.83nmol/min·ml)was higher than the control group,FGF19 level(91.18±8.64ng/L vs 122.63±10.29ng/L)level was lower than the control group,the differences were statistically significant(t=2.999~17.226,all P<0.05).Serum miR-351 level and LP-PLA2 activity in elderly patients with GDM were positively correlated with FPG,FINS,HOMA-IR,TG and LDL-C(r=0.408~0.584,all P<0.05).Serum FGF19 level was negatively correlated with FPG,FINS,HOMA-IR(r=-0.614~-0.386,all P<0.05),miR-351 was negatively correlated with FGF19 in elderly GDM pati
作者
张东方
王茜
李娟
庄敏敏
ZHANG Dong-fang;WANG Qian;LI Juan;ZHUANG Min-min(Department of Obstetrics,Tangshan Maternal and Child Health Hospital,Hebei Tangshan 063000,China)
出处
《现代检验医学杂志》
CAS
2023年第1期66-72,共7页
Journal of Modern Laboratory Medicine
基金
河北省医学科学研究课题计划项目(20221770)。
