| 李慧,刘艳芳,程明艳,等.妊娠糖尿病孕妇血清 NKX6-1表达与胰岛素抵抗及妊娠结局的相关性研究[J].安徽医药,2025,29(7):1454-1458. |
| 妊娠糖尿病孕妇血清 NKX6-1表达与胰岛素抵抗及妊娠结局的相关性研究 |
| Correlation of serum NKX6-1 expression with insulin resistance and pregnancy outcome in patients with gestational diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2025.07.038 |
| 中文关键词: 糖尿病，妊娠 NK6同源框蛋白 1 胰岛素抵抗 妊娠结局 胰岛 β细胞功能指数 胰岛素抵抗指数 |
| 英文关键词: Diabetes, gestational NK6 homeobox protein 1 Insulin resistance Pregnancy outcome β -cell function index Insulin resistance index |
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| 摘要点击次数: 764 |
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| 中文摘要: |
| 目的检测妊娠糖尿病孕妇血清中 NK6同源框蛋白 1(NKX6-1)的表达水平，分析与胰岛素抵抗及妊娠结局的相关性。方法随机选取 2020年 7月至 2022年 7月承德市妇幼保健院收治的妊娠糖尿病孕妇 100例为研究组，另外选取同期在该院定期进行产检的健康孕妇 80例为对照组。收集孕妇的一般临床资料，检测研究组和对照组血清 NKX6-1、空腹胰岛素( FINS)、腹血糖( FPG)水平，计算胰岛 β细胞功能指数( HOMA-β)与胰岛素抵抗指数( HOMA-IR)。采用 Pearson法分析血清 NKX6-1与空HOMA-IR、HOMA-β的相关性。根据研究组妊娠结局，分为良好组( n=61)与不良组( n=39)。单因素和多因素 logistic回归分析影响妊娠糖尿病孕妇妊娠结局的因素；受试者操作特征曲线( ROC曲线)分析血清 NKX6-1对妊娠糖尿病孕妇发生妊娠不良结局的预测价值。结果研究组血清 NKX6-1、HOMA-IR显著高于对照组［( 9.32±2.25)μg/L比( 5.63±1.27)μg/L、5.84±1.17比 2.18±0.51，P<0.05］；对照组 HOMA-β(117.24±17.38)显著高于研究组( 99.60±15.47)(P<0.05)。妊娠糖尿病孕妇血清 NKX6-1水平与 HOMA-IR呈正相关( r=0.50，P<0.05)与 HOMA-β呈负相关( r=.0.45，P<0.05)。研究组妊娠不良结局的发生率显著高于对照组( P<0.05)。 logistic分析显示年龄、腺功能和 NKX6-1是导致妊娠结局不良的危险因素( P<0.05)。 ROC曲线显示血甲状，清 NKX6-1水平预测妊娠糖尿病孕妇妊娠结局不良的 AUC是 0.85，灵敏度为 69.44%，特异度为 90.00%。结论妊娠糖尿病孕妇血清 NKX6-1水平高表达，与胰岛素抵抗呈正相关，有望成为妊娠糖尿病孕妇妊娠结局的预测因子。 |
| 英文摘要: |
| Objective To detect the expression level of NK6 homeobox protein 1 (NKX6-1) in serum of patients with gestational dia-betes mellitus (GDM), and to analyze its correlation with insulin resistance and pregnancy outcome.Methods One hundred patientswith GDM admitted to Chengde Maternal and Child Health Hospital from July 2020 to July 2022 were randomly selected as the re-search group. Another 80 healthy pregnant women who received regular obstetric examinations were regarded as the control group. Thegeneral clinical data of the patients were collected, and the levels of serum NKX6-1, fasting insulin (FINS), and fasting plasma glucose(FPG) in the study group and control group were measured, and the homeostatic model assessment of insulin resistance (HOMA-IR) and homeostatic model assessment of Beta-cell function (HOMA-β) were calculated. Pearson correlation was applied to analyze the correla-tion between serum NKX6-1 and HOMA-IR and HOMA-β. According to whether the patients in the study group had adverse pregnancyoutcomes, they were grouped into a good pregnancy outcome group (n=61) and a poor pregnancy outcome group (n=39). Univariate andmultivariate logistic regression were applied to analyze factors affecting pregnancy outcomes in patients with gestational diabetes melli-tus; receiver operating characteristic curves (ROC curves) were applied to analyze the predictive value of serum NKX6-1 for adverse pregnancy outcomes in patients with gestational diabetes mellitus. Results Serum NKX6-1 and HOMA-IR in the study group were greatly higher than those in the control group [(9.32±2.25) μg/L vs. (5.63±1.27) μg/L, 5.84±1.17 vs. 2.18±0.51, P<0.05]; HOMA-β in the control group (117.24±17.38) was greatly higher than that in the study group (99.60±15.47) (P<0.05). The level of serum NKX6-1 in patients with GDM was positively correlated with HOMA-IR (r=0.50, P<0.05), and negatively correlated with HOMA-β(r=.0.45, P< 0.05). The incidence of adverse pregnancy outcomes in the study group was significantly higher than that in the control group (P<0.05). Multivariate logistic regression analysis showed that age, thyroid function and NKX6-1 were risk factors for poor pregnancy outcome (P< 0.05). ROC curve showed that the AUC of serum NKX6-1 level in predicting poor pregnancy outcome in patients with GDM was 0.854,with a sensitivity of 69.44% and a specificity of 90.00%.Conclusion The high level of serum NKX6-1 in patients with GDM is posi-tively related to insulin resistance, which is expected to become a predictor of pregnancy outcome in patients with gestational diabetes. |
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