可溶性（原）肾素受体与妊娠期糖尿病的关联
Association of Soluble (Pro) Renin Receptor with Gestational Diabetes Mellitus.
作者信息
Gokulakrishnan Kuppan, Maheswari Kumar, Mahalakshmi Manni Mohanraj, Kalaiyarasi Gunasekaran, Bhavadharini Balaji, Pandey Gautam Kumar, Ramesh Jalaja, Ram Uma, Mohan Viswanathan
机构信息
WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control, IDF Centre for Education, Gopalapuram, Chennai, India.
St. Isabel's Hospital, Chennai, India.
出版信息
Endocr Pract. 2015 Jan;21(1):7-13. doi: 10.4158/EP14254.OR.
OBJECTIVE
There is a need to identify biomarkers for gestational diabetes mellitus (GDM). Recently the soluble pro-renin receptor (s[Pro]RR) has been shown to be associated with GDM. We investigated the association of s(Pro) RR levels in Asian Indians with GDM.
METHODS
We recruited 222 pregnant females, 147 without GDM (non-GDM) and 75 with GDM visiting antenatal clinics in Tamilnadu in South India. We included singleton pregnancy and excluded those with pre-existing diabetes mellitus or hypertension. Oral glucose tolerance tests (OGTTs) were performed, and GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Group criteria. s(Pro)RR was measured by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curves were used to identify s(Pro) RR cut-off points to identify GDM.
RESULTS
The mean levels of the s(Pro)RR were significantly higher in subjects with GDM (34.0 ± 12 ng/mL, P<.001) compared to non-GDM (21.4 ± 6.5 ng/mL). The proportions of subjects with GDM were 11 (15%) in the first tertile of s(Pro)RR (<19.61 ng/mL), 20 (27%) in the second (19.62-26.8 ng/mL), and 44 (59%) in the third tertile (>26.8 ng/mL). In multiple logistic regression analysis, s(Pro)RR showed a significant association with GDM (odds ratio [OR]: 1.201, 95% confidence interval [CI]: 1.065-1.355, P = .003) after adjusting for potential confounders. A s(Pro)RR cut-off of 23.3 ng/mL had a C statistic of 0.828 (95% CI: 0.738-0.918, P<.001), sensitivity of 68%, and specificity of 70% to identify GDM.
CONCLUSIONS
s(Pro)RR levels are higher in females with GDM, and this could be used as a potential biomarker.
目的
需要鉴定妊娠期糖尿病（GDM）的生物标志物。最近有研究表明，可溶性前肾素受体（s[Pro]RR）与GDM有关。我们调查了亚洲印度裔人群中s(Pro)RR水平与GDM的关联。
方法
我们招募了222名怀孕女性，其中147名无GDM（非GDM组），75名患有GDM，她们均在印度南部泰米尔纳德邦的产前诊所就诊。纳入单胎妊娠者，排除既往有糖尿病或高血压的患者。进行口服葡萄糖耐量试验（OGTT），并根据国际糖尿病与妊娠研究组的标准诊断GDM。采用酶联免疫吸附测定（ELISA）法检测s(Pro)RR。采用受试者工作特征（ROC）曲线确定用于识别GDM的s(Pro)RR截断点。
结果
与非GDM组（21.4±6.5 ng/mL）相比，GDM组受试者的s(Pro)RR平均水平显著更高（34.0±12 ng/mL，P<0.001）。s(Pro)RR第一三分位数（<19.61 ng/mL）中GDM患者比例为11例（15%），第二三分位数（19.62 - 26.8 ng/mL）中为20例（27%），第三三分位数（>26.8 ng/mL）中为44例（59%）。在多因素logistic回归分析中，校正潜在混杂因素后，s(Pro)RR与GDM显示出显著关联（比值比[OR]：1.201，95%置信区间[CI]：1.065 - 1.355，P = 0.003）。s(Pro)RR截断值为23.3 ng/mL时，C统计量为0.828（95% CI：0.738 - 0.918，P<0.001），识别GDM的灵敏度为68%，特异度为70%。
结论
GDM女性的s(Pro)RR水平较高，这可作为一种潜在的生物标志物。
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