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可溶性(原)肾素受体是妊娠期糖尿病的一个预测指标。

Soluble (Pro) Renin Receptor is a Predictor of Gestational Diabetes Mellitus.

作者信息

Bonakdaran Shokoufeh, Azami Ghazaleh, Tara Fatemeh, Poorali Leila

机构信息

Endocrine Research Center, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Postal Code: 91766. Iran.

Endocrine Research Center, Mashhad University of Medical Sciences, Mashhad. Iran.

出版信息

Curr Diabetes Rev. 2017;13(6):555-559. doi: 10.2174/1573399812666160919100253.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is a common endocrine complication in pregnancy. While it has been established that age, family history of diabetes, insulin resistance and several biomarkers are associated with GDM but significant gaps remain in understanding risk factors for GDM. Soluble pro-renin receptor (s [Pro] RR) as a biomarker reflects the activation of renin-angiotensin system in tissues which may be related to insulin resistance Objective: The aim of this study was to determine the role of (s [pro] RR) in predicting GDM.

METHODS

one hundred-eighty singleton pregnant women in first trimester were enrolled. We excluded women with previous history of GDM, hypertension and consumption of drugs affected reninangiotensin system. A fasting blood glucose and s (pro) RR level were obtained during first trimester and OGTT was performed at 24-28 weeks of gestation. We used ROC curves to identify s (pro) RR cutoff points for detecting GDM and the difference in s (pro)RR level was assessed in GDM and non- GDM women.

RESULTS

Among 180 women, 24 (13.33%) had GDM. There was no significant difference between age and body mass index in subjects with GDM compared to non- GDM. The concentration of s (pro) RR was significantly higher in GDM subjects rather than non- GDM [29.27(24.60-35.92) vs. 22.89(19.46- 24.27), P<0.001]. Multiple logistic regression analysis revealed a significant association of s(pro) RR with GDM (odd ratio: 1.32, 95% CI: 1.17-1.48, P=0.04). A cut-off point 24.52 ng/ml of s(pro) RR had 75% sensitivity and 80% specificity for predicting GDM.

CONCLUSION

Increased level of s (pro) RR in first trimester may be a marker for predicting GDM.

摘要

背景

妊娠期糖尿病(GDM)是孕期常见的内分泌并发症。虽然已经确定年龄、糖尿病家族史、胰岛素抵抗和几种生物标志物与GDM有关,但在理解GDM的危险因素方面仍存在显著差距。可溶性前肾素受体(s[Pro]RR)作为一种生物标志物,反映了组织中肾素-血管紧张素系统的激活,这可能与胰岛素抵抗有关。目的:本研究旨在确定(s[pro]RR)在预测GDM中的作用。

方法

招募了180名单胎妊娠早期妇女。我们排除了有GDM病史、高血压和服用影响肾素-血管紧张素系统药物的妇女。在妊娠早期获得空腹血糖和s(pro)RR水平,并在妊娠24-28周时进行口服葡萄糖耐量试验(OGTT)。我们使用ROC曲线确定检测GDM的s(pro)RR截断点,并评估GDM和非GDM妇女s(pro)RR水平的差异。

结果

180名妇女中,24名(13.33%)患有GDM。与非GDM相比,GDM患者的年龄和体重指数无显著差异。GDM患者的s(pro)RR浓度显著高于非GDM患者[29.27(24.60-35.92)对22.89(19.46-24.27),P<0.001]。多因素logistic回归分析显示s(pro)RR与GDM显著相关(比值比:1.32,95%CI:1.17-1.48,P=0.04)。s(pro)RR截断点为24.52 ng/ml时,预测GDM的敏感性为75%,特异性为80%。

结论

妊娠早期s(pro)RR水平升高可能是预测GDM的一个标志物。

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