Zhang Qian, Zhang Qing-Qing, Dong Shu-Qin, Liu Xia, Wei Jing, Li Kai, Lu Yu
Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China.
Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China.
Front Endocrinol (Lausanne). 2025 May 8;16:1486197. doi: 10.3389/fendo.2025.1486197. eCollection 2025.
To investigate the association of pancreatic duodenal homeobox-1 (PDX1) in early pregnancy with the risks of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes.
A total of 231 pregnant women were recruited at their initial antenatal care visit during 8-12 gestational weeks in this study. The 75g OGTT was performed during 24-28 gestational weeks. Blood samples were collected to measure PDX1 levels. Participants were followed throughout their pregnancy to monitor for the development of GDM and adverse pregnancy outcomes. The odds ratio (OR) was used to assess the risks of GDM and adverse pregnancy outcomes.
Pregnant women in the GDM group had higher levels of HOMA-IR and TyG index, and lower PDX1 levels both in early and mid-pregnancy (P<0.05), but had lower HOMA-β levels only in mid-pregnancy (P<0.05). PDX1 in early pregnancy was negatively correlated with FPG, 2h PG, HOMA-IR, and TyG, while positively correlated with HOMA-β in mid-pregnancy (P<0.05). The adjusted analysis showed that elevated PDX1 levels in early pregnancy were associated with reduced risks of GDM (aOR 0.287, 95%CI 0.130-0.636, P=0.002), macrosomia (aOR 0.249, 95%CI 0.076-0.811, P=0.021) and composite adverse pregnancy outcomes (aOR 0.496, 95%CI 0.256-0.960, P=0.037).
Elevated PDX1 in early pregnancy was associated with decreased risks of GDM and adverse pregnancy outcomes.
探讨妊娠早期胰腺十二指肠同源盒-1（PDX1）与妊娠期糖尿病（GDM）风险及不良妊娠结局的相关性。
本研究共纳入231例孕妇，她们在妊娠8-12周首次产前检查时入组。在妊娠24-28周进行75g口服葡萄糖耐量试验（OGTT）。采集血样以检测PDX1水平。对参与者整个孕期进行随访，监测GDM及不良妊娠结局的发生情况。采用比值比（OR）评估GDM及不良妊娠结局的风险。
GDM组孕妇在妊娠早期和中期的胰岛素抵抗指数（HOMA-IR）和甘油三酯葡萄糖指数（TyG指数）水平较高，而PDX1水平较低（P<0.05），但仅在妊娠中期HOMA-β水平较低（P<0.05）。妊娠早期的PDX1与空腹血糖（FPG）、餐后2小时血糖（2h PG）、HOMA-IR和TyG呈负相关，而与妊娠中期的HOMA-β呈正相关（P<0.05）。校正分析显示，妊娠早期PDX1水平升高与GDM风险降低（校正OR 0.287，95%可信区间0.130-0.636，P=0.002）、巨大儿（校正OR 0.249，95%可信区间0.076-0.811，P=0.021）及复合不良妊娠结局风险降低（校正OR 0.496，95%可信区间0.256-0.960，P=0.037）相关。
妊娠早期PDX1水平升高与GDM及不良妊娠结局风险降低相关。
