摘要
目的观察核因子-κB(NF-κB)、成纤维细胞生长因子19(FGF19)、胎盘生长因子(PLGF)在妊娠期糖尿病孕妇外周血中的表达及临床意义。方法以2023年7月至2024年7月为研究时间,前瞻性纳入唐山市妇幼保健院收治的40例妊娠期糖尿病患者为糖尿病组,纳入40名无妊娠期糖尿病的健康孕妇为对照组。比较两组孕妇的外周血NF-κB、FGF19、PLGF水平,分析外周血NF-κB与FGF19、PLGF的相关性。统计不良妊娠结局发生率,按照妊娠结局分为妊娠结局不良组与妊娠结局良好组,单因素和多因素Logistic回归分析影响的不良妊娠结局因素;应用受试者操作特征(ROC)曲线分析影响外周血NF-κB、FGF19、PLGF联合检测对妊娠期糖尿病的诊断效能。结果糖尿病组孕妇的外周血NF-κB水平分别为1.32±0.67,明显高于对照组(0.36±0.06),FGF19、PLGF水平为(56.42±12.45)、(82.28±18.66)pg/mL,均明显低于对照组[(65.40±17.23)、(163.72±24.74)pg/mL],差异均有统计学意义(P<0.05)。Pearson检验结果显示,外周血NF-κB与PLGF呈负相关(r=-0.610,P<0.01),与FGF19呈负相关(r=-0.783,P<0.01)。糖尿病组不良妊娠结局总发生率为37.50%,明显高于对照组(7.50%),差异有统计学意义(P<0.05)。单因素分析结果显示,年龄、空腹血糖、糖尿病家族史、外周血NF-κB、FGF19、PLGF水平与妊娠结局不良有关,差异均有统计学意义(P<0.05)。多因素Logistic分析结果显示,年龄,空腹血糖,糖尿病家族史,外周血NF-κB、FGF19、PLGF水平是导致妊娠糖尿病孕妇发生不良妊娠结局的高危因素(P<0.05)。ROC曲线分析结果显示外周血NF-κB、FGF19、PLGF水平联合检测诊断妊娠期糖尿病的曲线下面积、灵敏度、特异度均高于3种因子单一检测(P<0.05)。结论妊娠糖尿病孕妇的NF-κB、FGF19、PLGF水平均呈现出异常表达,临床可通过3种因子的联合检测诊断妊娠期糖尿病,预测不良妊娠结局并提前进行干预,改善妊娠结局并为产后2型糖尿病防治提供更多参考。
Objective To observe the expression of nuclear factor-κB(NF-κB),fibroblast growth factor 19(FGF19)and placental growth factor(PLGF)in peripheral blood of pregnant women with gestational diabetes mellitus and their clinical significance.Methods From July 2023 to July 2024,a total of 40 patients with gestational diabetes mellitus admitted to Tangshan Maternal and Child Health Hospital were prospectively included in the diabetes mellitus group,and 40 healthy pregnant women were included in the control group.The levels of NF-κB,FGF19 and PLGF in peripheral blood of the two groups were compared.The correlation between NF-κB and FGF19 and PLGF in peripheral blood was analyzed,and the incidence of adverse pregnancy outcomes was analyzed.The pregnant women in diabetic group were divided into adverse and good groups according to pregnancy outcomes.The influencing factors of adverse pregnancy outcomes were analyzed by univariate and multivariate Logistic regression analysis.The influence of peripheral blood NF-κB,FGF19,PLGF combined detection in the diagnosis of gestational diabetes mellitus was analyzed using receiver operating characteristic(ROC)curve.Results The level of NF-κB in peripheral blood of pregnant women in the diabetic group were 1.32±0.67,which were significantly higher than those in the control group(0.36±0.06),the levels of FGF19 and PLGF were(56.42±12.45)and(82.28±18.66)pg/mL,which were significantly lower than those in the control group[(65.40±17.23),(163.72±24.74)pg/mL],the differences were statistically significant(P<0.05).Pearson test results showed that peripheral blood NF-κB was negatively correlated with PLGF(r=-0.610,P<0.01)and negatively correlated with FGF19(r=-0.783,P<0.01).The total incidence of adverse pregnancy outcome in diabetes mellitus group(37.50%)was significantly higher than that in control group(7.50%),and the difference was statistically significant(P<0.05).Univariate analysis showed that age,fasting blood glucose,family history of diabetes mellitus,peripheral blood NF-κB,FGF19,and PLGF levels were associated with poor pregnancy outcomes,and the differences were statistically significant(P<0.05).Multivariate logistic analysis showed that age,fasting blood glucose,family history of diabetes mellitus,peripheral blood NF-κB,FGF19,and PLGF levels were high risk factors for adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus(P<0.05).ROC curve analysis showed that the area under the curve,sensitivity and specificity of the combined detection of NF-κB,FGF19 and PLGF levels in peripheral blood in the diagnosis of gestational diabetes mellitus were higher than those of the three factors alone(P<0.05).Conclusion The levels of NF-κB,FGF19 and PLGF in pregnant women with gestational diabetes mellitus show abnormal expression.The combined detection of these three factors can be used to diagnose gestational diabetes mellitus,predict adverse pregnancy outcomes and intervene in advance to improve pregnancy outcomes and provide more references for preventing postpartum type 2 diabetes mellitus.
作者
高英
李莉
杨玉侠
GAO Ying;LI Li;YANG Yu-xia(Department of Obstetrics and Gynecology,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,China)
出处
《临床和实验医学杂志》
2025年第2期195-199,共5页
Journal of Clinical and Experimental Medicine
基金
河北省卫健委科研计划项目(编号:20240715)。
