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母血清内皮细胞蛋白 C 受体水平是否为妊娠期糖尿病的新型标志物?

Is maternal serum endocan level a novel marker in gestational diabetes mellitus?

机构信息

Department of Obstetrics and Gynecology, Gaziosmanpaşa Training and Research Hospital, İstanbul, Turkey.

Department of Obstetrics and Gynecology, Ordu University Training and Research Hospital, Ordu, Turkey.

出版信息

J Obstet Gynaecol Res. 2023 Sep;49(9):2310-2316. doi: 10.1111/jog.15733. Epub 2023 Jul 2.

Abstract

AIM

To determine whether there was a significant difference between serum endocan levels of pregnant women with and without gestational diabetes mellitus (GDM).

METHODS

A total of 90 pregnant women, 45 with gestational diabetes and 45 healthy pregnant women, between 24 and 28 gestational weeks, were included in this prospective case-control study. The pregnant women were screened for gestational diabetes using a two-step protocol. Serum endocan levels were measured using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. A p-value of <0.05 was considered statistically significant.

RESULTS

Serum endocan level was significantly higher in the GDM group than in healthy controls (168.46 ± 160.6 vs. 105.66 ± 26.52 pg/mL, respectively; p < 0.001). Serum endocan concentrations were positively correlated with the results of 50 g oral glucose challenge test (GCT) (p < 0.001). Receiver operating characteristic curve analysis showed that endocan with a cut-off point of 133.9 ng/dL indicated women with GDM with a sensitivity of 55.6% and specificity of 88.9% (area under the curve [AUC]: 0.737, 95% CI: 0.634-0.824). The overall differential performance of endocan according to the GDM groups was determined as 73.7% (p < 0.001). Maternal serum endocan level was positively correlated with fasting glucose, postprandial glucose, and glycated hemoglobin (HbA1c) (p < 0.001).

CONCLUSIONS

Elevated endocan levels in gestational diabetes were correlated with fasting glucose, postprandial glucose, HbA1c, and oral glucose tolerance test (OGTT) results. Despite the low sensitivity of 55.6% and the high specificity of 88.9%, we found a high differential performance rate indicating that serum endocan levels were important for the pathophysiology of GDM and should be investigated for the possibility of being a novel marker in larger populations.

摘要

目的

确定患有和不患有妊娠期糖尿病(GDM)的孕妇血清中内脂素水平是否存在显著差异。

方法

本前瞻性病例对照研究纳入了 90 名孕妇,其中 45 名患有妊娠期糖尿病,45 名健康孕妇,孕周均为 24 至 28 周。孕妇采用两步法筛查妊娠期糖尿病。采用商业酶联免疫吸附测定(ELISA)试剂盒测定血清内脂素水平。p 值<0.05 为统计学显著差异。

结果

GDM 组血清内脂素水平明显高于健康对照组(分别为 168.46±160.6 和 105.66±26.52pg/mL;p<0.001)。血清内脂素浓度与 50g 口服葡萄糖耐量试验(GCT)结果呈正相关(p<0.001)。受试者工作特征曲线分析显示,内脂素截断点为 133.9ng/dL 时,诊断 GDM 的敏感性为 55.6%,特异性为 88.9%(曲线下面积[AUC]:0.737,95%置信区间:0.634-0.824)。根据 GDM 组确定内脂素的整体差异性能为 73.7%(p<0.001)。孕妇血清内脂素水平与空腹血糖、餐后血糖和糖化血红蛋白(HbA1c)呈正相关(p<0.001)。

结论

妊娠期糖尿病患者内脂素水平升高与空腹血糖、餐后血糖、HbA1c 和口服葡萄糖耐量试验(OGTT)结果相关。尽管敏感性为 55.6%,特异性为 88.9%较低,但我们发现高差异性能率表明血清内脂素水平对 GDM 的病理生理学很重要,应该在更大的人群中研究其作为一种新的标志物的可能性。

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