| 朱丽娟,王盼盼,张安红.妊娠期糖尿病病人血清 HSP70、HMGB1水平与胰岛素抵抗及妊娠结局的关系研究[J].安徽医药,2025,29(4):828-832. |
| 妊娠期糖尿病病人血清 HSP70、HMGB1水平与胰岛素抵抗及妊娠结局的关系研究 |
| Relationship between serum HSP70, HMGB1 levels and insulin resistance and pregnancy outcomes in patients with gestational diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2025.04.040 |
| 中文关键词: 妊娠期糖尿病 热休克蛋白 70 高迁移率族蛋白 B1 胰岛素抵抗 妊娠结局 |
| 英文关键词: Gestational diabetes mellitus Heat shock protein 70 High mobility group protein B1 Insulin resistance Pregnan. cy outcome |
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| 中文摘要: |
| 目的探究妊娠期糖尿病( GDM)病人血清热休克蛋白 70(HSP70)、高迁移率族蛋白 B1(HMGB1)水平与胰岛素抵抗(IR)及妊娠结局的关系。方法选取 2021年 5月至 2022年 5月于南京市江宁医院进行产检的并诊断为 GDM的孕妇 280例为研究对象，作为 GDM组，另选同期非糖尿病正常妊娠孕妇 280例作为对照组，收集受试者实验室指标及临床资料，随访受试者 6个月，记录胎儿窘迫、巨大儿、羊水过多、产后出血、胎膜早破等常见妊娠不良结局，比较 GDM组及对照组不良妊娠结局的发生率；血清中 HSP70、HMGB1表达水平与 IR及妊娠结局的相关性采用 Pearson法分析。结果 GDM组空腹血糖(FPG)、餐后 1h血糖( 1 h PG)、餐后 2h血糖( 2 hPG)、总胆固醇( TC)、三酰甘油( TG)、低密度脂蛋白胆固醇( LDL-C)、空腹胰岛素( FINS)、胰岛素抵抗指数( HOMA-IR)、 HSP70［( 0.35±0.13)μg/L］及 HMGB1［( 83.64±18.95)μg/L］水平均显著高于对照组［( 0.26±0.08)μg/L、(71.29±13.67)μg/L］，高密度脂蛋白胆固醇( HDL-C)显著低于对照组( P<0.05)；血清 HSP70与 FPG、1h PG、2 h PG、FINS及 HOMA-IR均呈正相关( r=0.44、0.37、0.40、0.63、0.59，P<0.05)血清 HMGB1与 FPG、1 h PG、2 h PG、FINS及 HOMA-IR均呈正相关( r=0.39、0.44、0.51、0.58、0.62，P<0.05)； GDM组不良妊娠结，局发生率( 40.00%，112/280)显著高于对照组( 4.29%，12/280)(P<0.05)；妊娠结局不良 GDM病人 FPG、1 h PG、2 h PG、FINS、HOMA-IR及血清 HSP70、HMGB1均显著高于妊娠结局良好 GDM病人( P<0.05)；血清 HSP70与胎儿窘迫、巨大儿、羊水过多、产后出血、胎膜早破均呈正相关( r=0.43、0.54、0.48、0.61、0.40，P<0.05)；血清 HMGB1与胎儿窘迫、巨大儿、羊水过多、产后出血、胎膜早破均呈正相关( r=0.66、0.71、0.58、0.49、0.55，P<0.05)；多因素 logistic回归分析结果显示， HOMA-IR、HSP70、HMGB1均是 GDM病人出现不良妊娠结局的危险因素。结论 GDM病人血清 HSP70、HMGB1高表达，且 HSP70、HMGB1均与 GDM病人 IR及妊娠结局显著相关。 |
| 英文摘要: |
| Objective To investigate the relationship between serum levels of heat shock protein 70 (HSP70), high mobility groupprotein B1 (HMGB1) and insulin resistance (IR) and pregnancy outcomes in patients with gestational diabetes mellitus (GDM).Methods A total of 280 pregnant women diagnosed as GDM who underwent prenatal examination in Nanjing Jiangning Hospitalfrom May 2021 to May 2022 were selected as the study subjects (GDM group), while 280 non-diabetic normal pregnant women ex.amined during the same period were selected as the control group. The laboratory indicators and clinical data of the subjects werecollected, and the subjects were followed up for 6 months, the common adverse pregnancy outcomes recorded, such as fetal distress,macrosomia, polyhydramnios, postpartum hemorrhage, and premature rupture of membranes. The incidences of adverse pregnancyoutcomes were compared between GDM group and control group; the correlation between the expressions of HSP70 and HMGB1 inserum and IR and pregnancy outcomes was analyzed by Pearson Correlation. Results The expression levels of fasting blood glu.cose (FPG), 1 h postprandial blood glucose (1 h PG), 2 h postprandial blood glucose (2 h PG), total cholesterol (TC), triglyceride(TG), low density lipoprotein cholesterol (LDL-C), fasting insulin (FINS), insulin resistance (HOMA-IR), HSP70 [(0.35±0.13) μg/L vs. (0.26±0.08) μg/L] and HMGB1 [(83.64±18.95) μg/L vs. (71.29±13.67) μg/L] were significant higher in GDM group than controlgroup, while the level of high density lipoprotein cholesterol (HDL-C) was obviously lower than control group (P<0.05). Serum HSP70 was positively correlated with FPG, 1h PG, 2h PG, FINS and HOMA-IR (r=0.44, 0.37, 0.40, 0.63, 0.59, respectively; P< 0.05), and serum HMGB1 was positively correlated with FPG, 1h PG, 2h PG, FINS and HOMA-IR (r=0.39, 0.44, 0.51, 0.58, 0.62, re. spectively; P<0.05). The incidence of adverse pregnancy outcomes in GDM group (40.00%, 112/280) was obviously higher than that incontrol group (4.29%, 12/280) (P<0.05); levels of FPG, 1 h PG, 2 h PG, FINS, HOMA-IR, serum HSP70 and HMGB1 in GDM patientswith poor pregnancy outcomes were significantly higher than those in GDM patients with good pregnancy outcomes (P<0.05). SerumHSP70 was positively correlated with fetal distress, macrosomia, polyhydramnios, postpartum hemorrhage and premature rupture ofmembranes (r=0.43, 0.54, 0.48, 0.61, 0.40, respectively; P<0.05); serum HMGB1 was positively correlated with fetal distress, macroso.mia, polyhydramnios, postpartum hemorrhage and premature rupture of membranes (r=0.66, 0.71, 0.58, 0.49, 0.55, respectively; P< 0.05). Multivariate logistic regression analysis results showed that HOMA-IR, HSP70 and HMGB1 were all risk factors for adverse preg. nancy outcomes in GDM patients. Conclusion Serum HSP70 and HMGB1 are highly expressed in GDM patients, and both of themare obviously correlated with IR and pregnancy outcomes in GDM patients. |
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