摘要
目的探讨微小RNA-15a(miR-15a)表达与妊娠期糖尿病(GDM)患者胎儿心脏畸形的关系。方法选取891例GDM患者作为疾病组,同时选取健康孕妇891例作为健康组,检测并比较2组母体血清miR-15a表达。根据疾病组是否发生胎儿心脏畸形将其分为畸形组和非畸形组,比较2组血清miR-15a表达及一般资料。另根据确诊孕周将疾病组患者分为A组和B组,根据空腹血糖升高程度将血糖控制不良患者分为C组和D组。采用多因素Logistic回归分析法分析GDM患者胎儿心脏畸形影响因素。绘制受试者工作特征(ROC)曲线分析血清miR-15a表达对GDM患者胎儿心脏畸形的预测价值。结果疾病组血清miR-15a表达高于健康组,差异有统计学意义(P<0.001)。GDM患者中胎儿心脏畸形发生率为2.87%(24/835)。畸形组血清miR-15a表达、年龄、孕前体质量指数和不良孕产史、血糖控制不良占比高于非畸形组,妊娠早期规律服用叶酸占比低于非畸形组,差异有统计学意义(P<0.05)。A组、B组的血清miR-15a表达、胎儿心脏畸形发生率比较,差异无统计学意义(P>0.05)。D组血清miR-15a表达、胎儿心脏畸形发生率高于C组,差异有统计学意义(P<0.05)。血清miR-15a表达(OR=16.651,95%CI:6.252~44.344)、年龄(OR=1.078,95%CI:1.006~1.156)、血糖控制不佳(OR=3.404,95%CI:1.852~5.137)是GDM患者胎儿心脏畸形的影响因素(P<0.05)。血清miR-15a表达预测GDM患者胎儿心脏畸形的最佳临界值、灵敏度、特异度、曲线下面积分别为2.34、87.50%、73.24%、0.827(95%CI:0.799~0.852)。结论在GDM患者中,血清miR-15a表达异常升高,其是预测GDM患者胎儿心脏畸形的有效指标。
Objective To investigate the relationship between the expression of microRNA-15a(miR-15a) and fetal heart malformation in patients with gestational diabetes mellitus(GDM).Methods A total of 891 patients with GDM were selected as disease group and 891 healthy pregnant women were selected as healthy group,the expression of serum miR-15a was detected and compared between the two groups.The disease group was divided into malformed group and non-malformed group according to whether fetal heart malformation occurred,serum miR-15a expression and general data of the two groups were compared.The patients in the disease group were divided into group A and group B according to the confirmed gestational age,and the patients with poor blood glucose control were divided into group C and group D according to the degree of fasting blood glucose elevation.Multivariate Logistic regression analysis was used to analyze the influencing factors of fetal heart malformation in GDM patients.Receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of serum miR-15a expression in fetal heart malformation in GDM patients.Results Serum miR-15a expression in the disease group was significantly higher than that in the healthy group( P <0.001).The incidence of fetal heart malformation in GDM patients was 2.87%( 24/835).The proportion of serum miR-15a expression,age,pre-pregnancy body mass index,adverse pregnancy history and poor blood glucose control in the malformed group was significantly higher than that in the non-malformed group,and the proportion of regular folic acid administration in early pregnancy was significantly lower than that in the non-malformed group( P < 0.05).There was no significant difference in serum miR-15a expression and incidence of fetal heart malformation between the group A and group B( P > 0.05).The expression of serum miR-15a and the incidence of fetal heart malformation in the group D were significantly higher than those in the group C( P < 0.05).Serum miR-15a expression( OR = 16.651,9
作者
王彦
周淑
于萍
余建
张瑞琪
WANG Yan;ZHOU Shu;YU Ping;YU Jian;ZHANG Ruiqi(China Birth Defects Monitoring Center,West China Second Hospital of Sichuan University,Chengdu,Sichuan,610000;Department of Obstetrics,Sichuan Jinxin Women and Children′s Hospital,Chengdu,Sichuan,610000)
出处
《实用临床医药杂志》
CAS
2024年第4期86-91,共6页
Journal of Clinical Medicine in Practice
基金
四川省科技计划项目(2018SZ0269)。
