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生长激素和胰岛素样生长因子-1轴对妊娠期糖尿病的预测价值:一项前瞻性队列研究。

Predictive value of growth hormone and insulin-like growth factor-1 axis for gestational diabetes mellitus: a prospective cohort study.

作者信息

Cui Lingling, Wang Yibo, Li Zhiqian, Yang Xiaoli, Zhou Huijun, Zhang Zhengya, Gao Yuting, Ji Linpu, Sun Ruijie, Qin Luying

机构信息

College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.

School of Nursing and Health , Zhengzhou University, Zhengzhou, 450001, Henan, China.

出版信息

BMC Endocr Disord. 2025 May 19;25(1):132. doi: 10.1186/s12902-025-01953-w.

Abstract

OBJECTIVE

This study aimed to explore the role of growth hormone/insulin-like growth factor-1 risk factor axis in gestational diabetes mellitus, as well as to rank independently risk factors.

METHODS

This was a prospective cohort study conducted between April 2019 and April 2022. The baseline data and serum samples were collected and analyzed from 241 pregnant women during the second trimester. Logistic regression and restricted cubic spline analyses were conducted to assess the relationship between GH and IGF-1 correlated with risk of GDM. Back-propagation artificial neural network (BPNN) and Receiver operating characteristic (ROC) curve analysis were performed to identify the predictive ability of the GH/IGF-1 axis for GDM.

RESULTS

The present study found that the higher serum levels of IGF-1 and the lower serum levels of GH in pregnant women were significantly correlated with risk of GDM. GH and IGF-1 were different in both case and control groups(P < 0.05). BPNN analysis identified IGF-1 as accounting for the highest proportion in the ranking of GDM risk prediction weights (up to 25.4%). Furthermore, the area under ROC curve (AUC) value of the GH and IGF-1 combinations reached 0.770 (95%CI:0.707, 0.83).

CONCLUSIONS

GH (growth hormone) and IGF-1 (insulin-like growth factor 1) are intricately linked to the development of gestational diabetes mellitus (GDM). Disruptions in the GH/IGF-1 axis can trigger insulin resistance, thereby elevating the risk of GDM.

TRIAL REGISTRATION

Current Controlled Trials: ChiCTR2000028811. Registration Date:20,200,104.

摘要

目的

本研究旨在探讨生长激素/胰岛素样生长因子-1风险因子轴在妊娠期糖尿病中的作用,并对独立风险因子进行排序。

方法

这是一项于2019年4月至2022年4月进行的前瞻性队列研究。收集并分析了241名孕妇孕中期的基线数据和血清样本。采用逻辑回归和受限立方样条分析来评估生长激素(GH)和胰岛素样生长因子-1(IGF-1)与妊娠期糖尿病风险的相关性。进行反向传播人工神经网络(BPNN)和受试者工作特征(ROC)曲线分析,以确定GH/IGF-1轴对妊娠期糖尿病的预测能力。

结果

本研究发现,孕妇血清IGF-1水平升高和血清GH水平降低与妊娠期糖尿病风险显著相关。GH和IGF-1在病例组和对照组中均存在差异(P<0.05)。BPNN分析确定IGF-1在妊娠期糖尿病风险预测权重排名中占比最高(高达25.4%)。此外,GH和IGF-1组合的ROC曲线下面积(AUC)值达到0.770(95%CI:0.707,0.83)。

结论

生长激素(GH)和胰岛素样生长因子-1(IGF-1)与妊娠期糖尿病(GDM)的发生密切相关。GH/IGF-1轴的紊乱可引发胰岛素抵抗,从而增加GDM的风险。

试验注册

国际临床试验注册平台:ChiCTR2000028811。注册日期:2020年10月4日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/838f/12087125/1e519c9b6cb7/12902_2025_1953_Fig1_HTML.jpg

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