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探讨血清超敏 C 反应蛋白、同型半胱氨酸、纤维蛋白原和网膜素-1水平对妊娠期糖尿病的预测价值。

Study on the predictive value of serum hypersensitive C-reactive protein, homocysteine, fibrinogen, and omentin-1 levels with gestational diabetes mellitus.

机构信息

Department of Clinical Laboratory, Hengshui People's Hospital, Hengshui, China.

出版信息

Gynecol Endocrinol. 2023 Dec;39(1):2183046. doi: 10.1080/09513590.2023.2183046.

Abstract

: To investigate whether hypersensitive C-reactive protein (Hs-CRP), homocysteine, fibrinogen, and omentin-1 could predict gestational diabetes mellitus (GDM) risk. : Case-control study was conducted at Hengshui People's Hospital. The GDM group included data about 150 patients aged between 22 and 35 years in 24-28 weeks. An equivalent comparative control group without GDM was composed of the same pool of patients. Body mass index (BMI), total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), oral glucose tolerance test (OGTT) 0-2h, hs-CRP, homocysteine, fibrinogen, and omentin-1 levels were studied in the serum samples of research groups. Univariate logistic regression analysis was used to explore the risk factors of GDM. The area under the curve (AUC) was calculated by the receiver operating characteristic curve (ROC) to analyze the predictive values. : Hs-CRP, homocysteine, and fibrinogen in GDM group were significantly higher than those in non-GDM group. Omentin-1 were significantly lower than those in non-GDM group. Logistic regression showed that hs-CRP, homocysteine, fibrinogen, and omentin-1 were risk factors for GDM. The AUC of the established GDM risk prediction model was 0.977, and the sensitivity and specificity were 92.10% and 98.70%, respectively; which were greater than that of hs-CRP, homocysteine, fibrinogen, and omentin-1 alone. Hs-CRP, homocysteine, fibrinogen, and omentin-1 in pregnancy have important clinical value for the prediction of GDM. We used these laboratory indications to establish a GDM risk prediction model that allows for early detection and treatment of GDM, lowering the morbidity of maternal and infant complications.

摘要

目的

探讨超敏 C 反应蛋白(hs-CRP)、同型半胱氨酸、纤维蛋白原和网膜素-1 是否可预测妊娠糖尿病(GDM)的发生风险。

方法

本研究采用病例对照研究,选取在衡水人民医院就诊的年龄 22-35 岁、孕 24-28 周的 GDM 患者 150 例作为 GDM 组,选取同期年龄匹配、无 GDM 的患者 150 例作为对照组。采集两组研究对象的血清样本,检测其体质量指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、口服葡萄糖耐量试验(OGTT)0-2 h 各指标以及 hs-CRP、同型半胱氨酸、纤维蛋白原和网膜素-1 水平。采用单因素 logistic 回归分析 GDM 的危险因素,采用受试者工作特征曲线(ROC)下面积(AUC)评估各指标预测 GDM 的价值。

结果

GDM 组患者血清 hs-CRP、同型半胱氨酸、纤维蛋白原水平均显著高于对照组,网膜素-1 水平显著低于对照组(均 P<0.05)。logistic 回归分析显示,hs-CRP、同型半胱氨酸、纤维蛋白原和网膜素-1 是 GDM 的危险因素。建立的 GDM 风险预测模型的 AUC 为 0.977,灵敏度和特异度分别为 92.10%和 98.70%,均大于 hs-CRP、同型半胱氨酸、纤维蛋白原和网膜素-1 单独预测时的 AUC。

结论

妊娠妇女血清 hs-CRP、同型半胱氨酸、纤维蛋白原和网膜素-1 对 GDM 的预测有重要的临床价值,联合这些实验室指标建立 GDM 风险预测模型,有助于 GDM 的早期发现和治疗,降低母婴并发症的发生风险。

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