| 摘要: |
| 目的 探讨血清摄食抑制因子1（NSF-1）、肥胖抑制素（OB）和胰高血糖素样肽1（GLP-1）水平对妊娠期糖尿病不良妊娠结局的预测价值。方法 选择2019年1月至2020年12月来我院就诊的妊娠期糖尿病患者122例（妊娠糖尿病组）及同期来我院进行产前检查的健康孕妇75例（正常妊娠组）作为研究对象。采集静脉血进行检测，比较两组血清NSF-1、OB和GLP-1水平的差异，分析妊娠期糖尿病患者血清NSF-1、OB和GLP-1水平与血糖控制程度的关系，对妊娠结局不良的妊娠期糖尿病患者进行单因素和多因素二元logistic回归分析，绘制ROC曲线评价血清NSF-1、OB和GLP-1水平对预测妊娠期糖尿病妊娠结局不良的诊断效能。结果 妊娠期糖尿病组血清NSF-1水平高于正常妊娠组（P<0.01），且随着孕周的增加及血糖控制良好程度的升高而升高（P均<0.01）；而血清OB和GLP-1水平低于正常妊娠组（P<0.01），且随着孕周的增加和血糖控制良好程度的升高而下降（P均<0.01）。妊娠结局不良组血清HbA1c和NSF-1水平高于妊娠结局良好组（P均<0.01），而血清OB和GLP-1水平低于妊娠结局良好组（P均<0.01）。经多因素二元logistic回归分析发现，血清NSF-1、OB和GLP-1水平是妊娠结局不良的独立预后影响因素（P均<0.01）。血清NSF-1、OB和GLP-1水平对预测妊娠期糖尿病患者妊娠结局不良具有较高的诊断效能，联合检测的灵敏度为97.4%，特异度83.3%，AUC为0.966，高于单个指标NSF-1（Z=4.078，P<0.01）、OB（Z=4.059，P<0.05）和GLP-1（Z=2.918，P<0.01）。结论 妊娠期糖尿病患者血清NSF-1、OB和GLP-1水平是妊娠结局不良的危险因素，在预测妊娠结局不良方面具有较高的诊断效能。 |
| 关键词: 摄食抑制因子1 肥胖抑制素 胰高血糖素样肽1 妊娠糖尿病 妊娠结局 |
| DOI：10.16781/j.0258-879x.2021.12.1428 |
| 投稿时间：2021-07-19 |
| 基金项目: |
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| Predictive value of serum nesfatin 1, obestatin and glucagon-like peptide 1 levels in adverse pregnancy outcomes of patients with gestational diabetes mellitus |
| XU Yan,LI Lin-xia* |
(Department of Obstetrics and Gynaecology, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the predictive value of serum nesfatin 1 (NSF-1), obestatin (OB) and glucagon-like peptide 1 (GLP-1) levels for the adverse pregnancy outcomes of patients with gestational diabetes mellitus (GDM).Methods From Jan. 2019 to Dec. 2020, 122 GDM women (GDM group) and 75 healthy pregnant women (normal pregnancy group) who visited our hospital were enrolled. The venous blood was collected to compare the levels of serum NSF-1, OB and GLP-1 in the 2 groups, and the relationship between the levels of serum NSF-1, OB and GLP-1 and the degree of blood glucose control in GDM patients was analyzed. Univariate and multivariate binary logistic regression analyses were performed in GDM patients with poor pregnancy outcomes, and ROC curves were drawn to evaluate the diagnostic efficacy of serum NSF-1, OB and GLP-1 levels in predicting poor pregnancy outcomes of GDM patients.Results The serum NSF-1 level in the GDM group was significantly higher than that in the normal pregnancy group (P < 0.01), and increased with the increase of gestational week and the improvement of blood glucose control (both P < 0.01). The serum levels of OB and GLP-1 were significantly lower in the GDM group (P < 0.01), and decreased with the increase of gestational week and the improvement of blood glucose control (all P < 0.01). The serum levels of glycosylated hemoglobin (HbA1c) and NSF-1 in the poor pregnancy outcome group were significantly higher than those in the good pregnancy outcome group (both P < 0.01), while the serum levels of OB and GLP-1 were significantly lower in the good pregnancy outcome group (both P < 0.01). Multivariate binary logistic regression analysis showed that the levels of serum NSF-1, OB and GLP-1 were independent prognostic factors of poor pregnancy outcomes (all P < 0.01). The serum levels of NSF-1, OB and GLP-1 had a higher diagnostic efficiency in predicting poor pregnancy outcomes of GDM patients. The sensitivity of the combined detection was 97.4%, specificity was 83.3% and AUC was 0.966, which was significantly higher than those of the single index (NSF-1[Z=4.078, P < 0.01], OB[Z=4.059, P < 0.05] and GLP-1[Z=2.918, P < 0.01]).Conclusion The levels of serum NSF-1, OB and GLP-1 in GDM patients are risk factors of poor pregnancy outcomes, and have high diagnostic efficiency in predicting poor pregnancy outcomes. |
| Key words: nesfatin 1 obestatin glucagon-like peptide 1 gestational diabetes pregnancy outcome |
