| 符梅沙,吴小妹.晚期妊娠糖尿病血清总蛋白、视黄醇结合蛋白 4水平与胎儿生长受限的相关性分析[J].安徽医药,2021,25(7):1383-1386. |
| 晚期妊娠糖尿病血清总蛋白、视黄醇结合蛋白 4水平与胎儿生长受限的相关性分析 |
| Correlation analysis of serum TP and RBP4 levels with fetal growth restriction in patients with advanced gestational diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2021.07.028 |
| 中文关键词: 胎儿生长迟缓 糖尿病，妊娠 总蛋白 视黄醇结合蛋白 4 相关性 |
| 英文关键词: Fetal growth retardation Diabetes, gestational Total protein Retinol binding protein 4 Correlation |
| 基金项目: |
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| 中文摘要: |
| 目的探究总蛋白( TP)、视黄醇结合蛋白 4(RBP4)在晚期妊娠糖尿病( GDM)病人血清中水平与胎儿生长受限( FGR)的关系。方法选取 2017年 3月至 2019年 10月海南医学院第一附属医院确诊的 142例晚期 GDM病人进行研究，其中发生 FGR的 40例为 FGR组，新生儿出生体质量正常的 102例为正常体质量组。分析比较两组临床资料；检测并比较两组孕妇血清 TP水平；以酶联免疫吸附法( ELISA)检测两组孕妇血清 RBP4水平；采用受试者特征工作曲线( ROC)评价血清 TP、RBP4水平对 FGR的诊断价值； logistic回归分析晚期 GDM病人发生 FGR的影响因素。结果 FGR组孕妇血清空腹血糖( FBG)、空腹胰岛素( FINS)、稳定型评价胰岛素抵抗指数( HOMA-IR)、 RBP4水平均明显高于正常体质量组［( 5.35±1.48)比( 4.22±1.27)mmol/L，(81.52±39.67)比( 72.87±33.54)pmmol/L，(18.16±5.53)比( 12.42±4.46)，(40.47±9.23)比( 26.95±6.12)mg/L］(P<0.05)血清 TP水平明显低于正常体质量组［(52.56±7.15)比( 68.98±9.53)g/L］(P<0.05)；血清 TP、RBP4水平对 FGR诊断的曲线下面积(，AUC)分别为 0.872、0.823，截断值分别为 63.99 g/L、30.44 mg/L，此时相应灵敏度分别为 86.7%、72.4%，对应特异度分别为 75.5%、77.5%，血清 TP、RBP4联合诊断 FGR的 AUC为 0.921，其灵敏度、特异度分别为 75.5%、94.1%；FBG、HOMA-IR、RBP4是影响晚期 GDM发生 FGR的危险因素( P<0.05)TP是影响晚期 GDM发生 FGR的保护因素( P<0.05)。结论晚期 GDM病人血清 TP、RBP4水平与 FGR密切相关，两者水平有助，于预测晚期 GDM病人发生 FGR。 |
| 英文摘要: |
| Objective To investigate the relationships between the levels of serum total protein (TP) and retinol binding protein 4(RBP4) and fetal growth restriction (FGR) in gestational diabetes mellitus (GDM).Methods A total of 142 patients with advancedGDM diagnosed in The First Affiliated Hospital of Hainan Medical College from March 2017 to October 2019 were selected for thestudy, among them, 40 cases with FGR were in FGR group and 102 cases of newborns with normal body mass were in normal bodymass group. The clinical data of the two groups were analyzed and compared; the level of TP of patients in the two groups was detectedand compared; the level of serum RBP4 of patients in the two groups was detected with enzyme-linked immunosorbent assay (ELISA);the diagnostic value of TP and RBP4 in serum to FGR was evaluated with receiver operating characteristic (ROC); the influencing factors of FGR in advanced GDM patients were analyzed by logistic regression.Results The levels of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment-insulin resistance (HOMA-IR) and RBP4 in the FGR group were significantly higher than those in the normal body mass group [(5.35±1.48) vs. (4.22±1.27) mmol/L, (81.52±39.67) vs. (72.87±33.54) pmmol/L, (18.16±5.53) vs. (12.42±4.46), (40.47±9.23) vs. (26.95±6.12) mg/L] (P < 0.05), the level of serum TP was significantly lower than that in the normal body mass group [(52.56±7.15) vs. (68.98±9.53) g/L] (P < 0.05); the area under curve (AUC) of serum TP and RBP4 in the diagnosis ofFGR was 0.872 and 0.823, respectively, the cutoff values were 63.99 g/L and 30.44 mg/L, respectively, the corresponding sensitivitywas 86.7% and 72.4%, respectively, and the corresponding specificity was 75.5% and 77.5%, respectively, the AUC of serum TP andRBP4 in the diagnosis of FGR was 0.921, the sensitivity and specificity were 75.5% and 94.1%, respectively; FBG, HOMA-IR and RBP4 were the risk factors of FGR in advanced GDM (P < 0.05), TP was the protective factor of FGR in advanced GDM (P < 0.05). Conclusions The serum levels of TP and RBP4 are closely related to FGR in patients with advanced GDM, which are helpful to predict the occurrence of FGR in patients with advanced GDM. |
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