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妊娠早期初次产前检查中补体因子 Ba 水平较高会增加随后发生妊娠期糖尿病的风险:一项倾向评分匹配研究。

High level of complement factor Ba within first prenatal test of gestation increases the risk of subsequent gestational diabetes: a propensity score-matched study.

机构信息

Department of Endocrinology & Metabolism, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China.

Department of Endocrinology & Metabolism, Shanghai Jiao-Tong University School of Medicine Affiliated Shanghai General Hospital, Shanghai, China.

出版信息

Gynecol Endocrinol. 2022 Feb;38(2):158-163. doi: 10.1080/09513590.2021.1989400. Epub 2021 Oct 13.

Abstract

OBJECTIVE

This study was to assess the alteration of circulating complement factor Ba (CFBa) within 11 to 17 weeks of gestation and its association with subsequent gestational diabetes mellitus (GDM) and its delivery outcome.

METHODS

Biochemical parameters and blood samples were collected from 399 pregnant women within 11 to 17 weeks of gestation. At 24 to 28 weeks of gestation, all participants underwent 75-g oral glucose tolerance test and were assigned to GDM group ( = 80) and normal control group ( = 319). Perinatal data were collected after delivery. A propensity score-matched (PSM) analysis was performed to reduce the impact of confounding factors on glucose metabolism during pregnancy between the two groups.

RESULTS

Two groups of 74 well-matched patients who maintained balance in terms of baseline characteristics. The levels of CFBa in pregnant women who later developed GDM were significantly higher than those in healthy pregnant women [0.4(0.1-0.8) 0.2(0.2-0.3),  = 0.024]. Logistic regression analysis results confirmed that the level of CFBa was an independent impact factor for the occurrence of GDM (OR = 1.57, 95% CI: 1.118-2.210,  = 0.009). Further grouping according to the median level of CFBa, it was found that the incidence of GDM in category two (>0.23 ng/ml,  = 74) was markedly higher than that in the first category (≤0.23 ng/ml,  = 74) ( = 0.021).

CONCLUSIONS

High level of the CFBa within 11 to 17 weeks of gestation increases the risk of subsequent GDM, and maybe a biomarker for predicting GDM.

摘要

目的

本研究旨在评估妊娠 11 至 17 周时循环补体因子 Ba(CFBa)的变化及其与随后发生的妊娠期糖尿病(GDM)及其分娩结局的关系。

方法

对 399 名妊娠 11 至 17 周的孕妇采集生化参数和血样。在 24 至 28 周时,所有参与者均进行 75g 口服葡萄糖耐量试验,并分为 GDM 组(n=80)和正常对照组(n=319)。分娩后收集围产期数据。采用倾向评分匹配(PSM)分析来减少两组在妊娠期间葡萄糖代谢方面混杂因素的影响。

结果

两组各有 74 例匹配良好的患者,在基线特征方面保持平衡。后来发生 GDM 的孕妇的 CFBa 水平明显高于健康孕妇[0.4(0.1-0.8)比 0.2(0.2-0.3),=0.024]。Logistic 回归分析结果证实 CFBa 水平是 GDM 发生的独立影响因素(OR=1.57,95%CI:1.118-2.210,=0.009)。根据 CFBa 中位数进一步分组发现,CFBa 水平处于第二类(>0.23ng/ml,n=74)的 GDM 发生率明显高于第一类(≤0.23ng/ml,n=74)(=0.021)。

结论

妊娠 11 至 17 周时 CFBa 水平升高增加了随后发生 GDM 的风险,可能是预测 GDM 的生物标志物。

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