摘要
目的探讨血清硒蛋白P、Kisspeptin对妊娠期糖尿病(GDM)孕妇产后糖代谢异常发生的影响,并评估其预测价值。方法选取医院2019年9至2020年9收治的GDM孕妇186例,产后3个月复查口服葡萄糖耐量试验(OGTT),并以此结果分为正常组(126例)和异常组(60例)。比较孕中期血清硒蛋白P、Kisspeptin水平,通过受试者工作特征曲线(ROC)分析其对糖代谢异常影响与预测;采用Logistics回归模型分析糖代谢异常影响因素。结果异常组孕妇孕中期血清硒蛋白P水平显著低于正常组,血清Kisspeptin水平显著高于正常组(P<0.05)。ROC曲线显示,GDM孕妇孕中期硒蛋白P和Kisspeptin水平最佳临界值分别为2.84 mmol/L和53.80 ng/L,药时曲线下面积(AUC)分别为0.783[95%CI(0.712,0.853)]和0.802[95%CI(0.736,0.868)],灵敏度分别为73.81%和73.02%,特异度分别为65.00%和66.67%。单因素分析结果显示,孕前体质量指数(BMI)、孕期增重、糖尿病家族史、孕中期硒蛋白P和Kiss-peptin水平是GDM孕妇产后糖代谢异常的影响因素。多因素分析结果显示,孕前BMI≥24 kg/m^(2)、孕期增重较多、合并糖尿病家族史、孕中期硒蛋白P<2.84 mmol/L、Kisspeptin≥53.80 ng/L是GDM孕妇产后糖代谢异常的独立危险因素。结论硒蛋白P水平过低及Kisspeptin水平过高是GDM孕妇产后糖代谢异常的独立危险因素,能早期预测GDM孕妇产后糖代谢异常的发生。
Objective To investigate the effect of serum selenoprotein P and Kisspeptin on the postpartum abnormal glucose metabolism in pregnant women with gestational diabetes mellitus(GDM),and to evaluate their predictive value.Methods A total of 186 pregnant women with GDM admitted to the hospital from September 2019 to September 2020 were selected.Oral glucose tolerance test(OGTT)was performed at three months after postpartum,on this basis,they were divided into the normal group(126 cases)and the abnormal group(60 cases).The levels of serum selenoprotein P and Kisspeptin in the second trimester of pregnancy were compared,and their effect and prediction on abnormal glucose metabolism was analyzed by the receiver operating characteristic curve(ROC).Logistic regression model was used to analyze the influencing factors of abnormal glucose metabolism.Results The serum selenoprotein P level in the abnormal group was significantly lower than that in the normal group during the second trimester of pregnancy,and the serum Kisspeptin level was significantly higher than that in the normal group(P<0.05).The ROC showed that the optimal critical values for selenium protein P and Kisspeptin levels of GDM pregnant women in the second trimester were 2.84 mmol/L and 53.80 ng/L respectively,AUC was 0.783[95%CI(0.712,0.853)and 0.80295%CI(0.736,0.868)]respectively,sensitivity was 73.81%and 73.02%respectively,specificity was 65.00%and 66.67%respectively.The results of univariate analysis showed that the body mass index(BMI)before pregnancy,weight gain during pregnancy,family history of diabetes mellitus,selenoprotein P and Kiss peptin levels during the second trimester of pregnancy were the influencing factors of abnormal postnatal glucose metabolism in GDM pregnant women.Multivariate analysis showed that BMI≥24 kg/m^(2) before pregnancy,more weight gain during pregnancy,family history of diabetes mellitus,selenoprotein P<2.84 mmol/L,Kisspeptin≥53.80 ng/L were the independent risk factors for abnormal postpartum glucose metabolism in GDM pregnant women.Conclusion Low level of selenoprotein P and high level of Kisspeptin are independent risk factors for postpartum abnormal glucose metabolism in GDM pregnant women,and can early predict the occurrence of postpartum abnormal glucose metabolism in GDM pregnant women.
作者
常倩
CHANG Qian(Department of the First Obstetrics,The Second People's Hospital of Liaocheng,Liaocheng,Shandong,China 252600)
出处
《中国药业》
CAS
2023年第S01期213-215,共3页
China Pharmaceuticals
