Yu Fan, Zhou Wenjie, Tan Xi, Jiang Yongmei
Clin Lab. 2019 Jan 1;65(1). doi: 10.7754/Clin.Lab.2018.180550.
The study aimed to investigate the relationship between plasma amylase levels and the endocrine and metabolic biomarkers in Chinese pregnant women with gestational diabetes mellitus (GDM) in the southwest of China and to compare plasma amylase with other known biomarkers in relation to their contributions to identifying GDM, with a view to establishing plasma amylase as an independent laboratory-based risk factor for GDM.
This study included 1,870 pregnant women divided into three groups: early pregnancy, middle pregnancy, and late pregnancy according to weeks of gestation, and 164 pregnant women were excluded by diseases. Fasting samples of participants were collected and plasma amylase and other metabolic markers were measured. The pregnant women were identified as having GDM by a 75 g oral glucose tolerance test performed between the 24th and the 28th week of gestation. Multivariate logistic regression was used to examine the associations between the amylase and the prevalence of GDM in pregnant women.
Significant differences were found in plasma amylase and metabolic markers in different trimesters of pregnancy. For the pregnant women with GDM, fasting plasma glucose (FPG), 1hPG, 2hPG, HOMA-IR, and plasma amylase levels were all statistically different when compared with the pregnant women without GDM. The plasma amylase levels in 24th - 28th week of pregnant women (628) were negatively correlated with FPG, 1hPG, HOMA-IR, age, and the endocrine and metabolic biomarkers. Following adjustment for age, HOMA-IR, and FPG, multivariate logistic regression showed that plasma amylase level was the independent factor predicting GDM in 24th - 28th week of pregnant women.
The plasma amylase of GDM women are higher compared to healthy pregnant women, suggesting the plasma amylase levels are associated with GDM patients. Given the growing incidence of GDM, it provides an opportunity for primary intervention strategies which would not only improve the health of mother and fetus but also decrease the risk of GDM.
本研究旨在调查中国西南部妊娠期糖尿病(GDM)孕妇血浆淀粉酶水平与内分泌和代谢生物标志物之间的关系,并比较血浆淀粉酶与其他已知生物标志物在识别GDM方面的贡献,以期将血浆淀粉酶确立为基于实验室的GDM独立危险因素。
本研究纳入1870名孕妇,根据孕周分为早孕、中孕和晚孕三组,164名孕妇因疾病被排除。采集参与者的空腹样本,检测血浆淀粉酶和其他代谢标志物。通过在妊娠第24至28周进行的75g口服葡萄糖耐量试验,将孕妇确定为患有GDM。采用多因素logistic回归分析血浆淀粉酶与孕妇GDM患病率之间的关联。
在妊娠不同孕期,血浆淀粉酶和代谢标志物存在显著差异。对于患有GDM的孕妇,与未患GDM的孕妇相比,空腹血糖(FPG)、1小时血糖(1hPG)、2小时血糖(2hPG)、胰岛素抵抗指数(HOMA-IR)和血浆淀粉酶水平均有统计学差异。孕妇在第24至28周时的血浆淀粉酶水平(628)与FPG、1hPG、HOMA-IR、年龄以及内分泌和代谢生物标志物呈负相关。在调整年龄、HOMA-IR和FPG后,多因素logistic回归显示,血浆淀粉酶水平是预测孕妇在第24至28周时患GDM的独立因素。
与健康孕妇相比,GDM孕妇的血浆淀粉酶水平较高,表明血浆淀粉酶水平与GDM患者有关。鉴于GDM发病率不断上升,这为初级干预策略提供了机会,该策略不仅可以改善母婴健康,还可以降低GDM的风险。