Li Qian, Li Chunmei, Jin Jing, Shen Yang, Wang Mei
Department of Obstetrics and Gynecology, Dongxihu People's Hospital, Wuhan, China.
Endocrine Department, Dongxihu People's Hospital, Wuhan, China.
Evid Based Complement Alternat Med. 2022 Aug 28;2022:2829662. doi: 10.1155/2022/2829662. eCollection 2022.
This study aims to explore the serum levels of neuregulin 4 (NRG4), afamin (AFM), and serpin family B member 1 (SERPINB1) in gestational diabetes mellitus (GDM) patients and their relationship with insulin resistance.
Serum levels of AFM, SERPINB1, and NRG4 were measured in GDM ( = 58), and non-GDM women ( = 60) using enzyme-linked immunosorbent assay (ELISA) kits. Besides, the serum insulin and glucose levels were also measured followed by calculating the homeostatic model assessment of insulin resistance (HOMA-IR). The correlation was performed using the Pearson analysis.
The increased serum levels of AFM and SERPINB1 were revealed in GDM patients as compared with non-GDM women, accompanied by the lower NRG4 serum level. ROCs for AFM concentrations showed an AUC of 0.629 (95% CI: 0.527∼0.731), 0.832 (95% CI: 0.754∼0.909) for the SERPINB1 serum level, and 0.626 (95% CI: 0.524∼0.728) for the NRG4 serum level. The threshold was 108.05 mg/L, 8.75 ng/mL, and 96.25 ng/mL of AFM, SERPINB1, and NRG4. Moreover, the combined ROC of AFM, SERPINB1, and NRG4 serum levels showed higher sensitivity (72.41%) and specificity (85.00%) for the diagnosis of GDM (AUC = 0.839; 95% CI: 0.764∼0.913). In GDM patients, the Pearson analysis revealed a significant correlation between AFM and SERPINB1 ( = 0.776), AFM and NRG4 ( = -0.799), as well as SERPINB1 and NRG4 ( = -0.783). Moreover, AFM and SERPINB1 serum concentrations in GDM patients were positively related to insulin levels, fasting glucose levels, and HOMA-IR values. However, the SERPINB1 serum level was negatively correlated with serum insulin and glucose levels and HOMA-IR.
Abnormal serum levels of NRG4, AFM, and SERPINB1, as highly sensitive diagnostic tools, are closely related to insulin resistance in GDM patients.
本研究旨在探讨妊娠糖尿病（GDM）患者血清中神经调节蛋白4（NRG4）、载脂蛋白A（AFM）和丝氨酸蛋白酶抑制剂B1（SERPINB1）的水平及其与胰岛素抵抗的关系。
采用酶联免疫吸附测定（ELISA）试剂盒检测58例GDM患者和60例非GDM女性血清中AFM、SERPINB1和NRG4的水平。此外，还检测了血清胰岛素和血糖水平，随后计算胰岛素抵抗稳态模型评估（HOMA-IR）。采用Pearson分析进行相关性分析。
与非GDM女性相比，GDM患者血清中AFM和SERPINB1水平升高，同时NRG4血清水平降低。AFM浓度的ROC曲线下面积（AUC）为0.629（95%可信区间：0.527～0.731），SERPINB1血清水平的AUC为0.832（95%可信区间：0.754～0.909），NRG4血清水平的AUC为0.626（95%可信区间：0.524～0.728）。AFM、SERPINB1和NRG4的阈值分别为108.05mg/L、8.75ng/mL和96.25ng/mL。此外，AFM、SERPINB1和NRG4血清水平的联合ROC曲线对GDM诊断的敏感性较高（72.41%），特异性较高（85.00%）（AUC=0.839；95%可信区间：0.764～0.913）。在GDM患者中，Pearson分析显示AFM与SERPINB1之间存在显著相关性（r=0.776），AFM与NRG4之间存在显著相关性（r=-0.799），SERPINB1与NRG4之间存在显著相关性（r=-0.783）。此外，GDM患者的AFM和SERPINB1血清浓度与胰岛素水平、空腹血糖水平和HOMA-IR值呈正相关。然而，SERPINB1血清水平与血清胰岛素、血糖水平和HOMA-IR呈负相关。
NRG4、AFM和SERPINB1的血清水平异常作为高灵敏度的诊断工具，与GDM患者的胰岛素抵抗密切相关。
