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.
J Obstet Gynaecol Res. 2023 Sep;49(9):2310-2316. doi: 10.1111/jog.15733. Epub 2023 Jul 2.
To determine whether there was a significant difference between serum endocan levels of pregnant women with and without gestational diabetes mellitus (GDM).
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.
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).
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.
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。
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。
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)。
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。