妊娠早期血清脂素蛋白1、瘦素、脂联素与妊娠期糖尿病的相关性研究

Association of early pregnancy serum Lipin1, leptin, and adiponectin with gestational diabetes mellitus

摘要

目的 探讨妊娠早期血清脂素蛋白1(Lipin1)、瘦素、脂联素与妊娠期糖尿病(GDM)发生之间的关联,并分析其对GDM的预测价值。方法 本研究招募了60名于2023年6月至12月期间在湖北医药学院附属国药东风总医院接受产检的孕妇.在妊娠早期(孕7~13周)采集血清样本,24~28周时通过75g口服葡萄糖耐量试验(OGTT)将研究对象分为两组即GDM组(30例)、健康对照组(30例).检测两组受试者血清中Lipin1和脂肪因子(瘦素、脂联素)的水平,采用Pearson相关分析探究两组人群血清中Lipin1和脂肪因子(瘦素、脂联素)的关联性,并通过ROC曲线评估其对GDM的预测价值。结果 妊娠期糖尿病(GDM)组血清中脂联素和脂素蛋白1水平显著低于健康对照组,而瘦素水平则明显高于对照组,这些差异在统计学上具有显著性(t值分别为12．476、9．621、-12．263,P＜0．001).Pearson相关分析显示,GDM组中Lipin1水平与脂联素显著正相关(r＝0．919,P＜0．001),与瘦素显著负相关(r＝-0．826,P＜0．001).ROC曲线分析表明,在脂联素、瘦素和Lipin1三项指标中,Lipin1在预测妊娠期糖尿病方面表现出极高的诊断效能,其受试者工作特征曲线下面积达到0．986.当以54．72pg/mL作为临界阈值时灵敏度和特异度分别为90．00％和100．00％,约登指数为0．950。结论 妊娠期糖尿病的发生与血清Lipin1及脂联素浓度存在显著关联.其中,Lipin1与脂联素水平呈正向关联,与瘦素水平呈负向关联,二者对妊娠期糖尿病具有一定的预测价值.

Abstract

Objective To investigate the association between serum Lipin1, leptin, and adiponectin levels in early pregnancy and the occurrence of gestational diabetes mellitus (GDM), and to analyze their predictive value for GDM. Methods A total of 60 pregnant women who underwent prenatal examinations at Sinopharm Dongfeng General Hospital Affiliated to Hubei University of Medicine from June to December 2023 were recruited. Serum samples were collected during early pregnancy (7-13 weeks of gestation). At 24-28 weeks, all participants underwent a 75g oral glucose tolerance test (OGTT) and were divided into the GDM group (n=30) and the healthy control group (n=30). Serum levels of Lipin1 and adipokines (leptin, adiponectin) were measured. Pearson correlation analysis was performed to assess associations among Lipin1, leptin, and adiponectin, and receiver operating characteristic (ROC) curve analysis was used to evaluate their predictive value for GDM. Results Compared with the healthy control group, the GDM group had significantly lower serum levels of adiponectin and Lipin1, but significantly higher levels of leptin (t=12．476, 9．621 and -12．263, respectively, all P<0．001). Pearson correlation analysis showed that in the GDM group, Lipin1 levels were positively correlated with adiponectin (r=0．919, P<0．001) and negatively correlated with leptin (r=-0．826, P<0．001). ROC curve analysis indicated that among adiponectin, leptin, and Lipin1, Lipin1 demonstrated the highest diagnostic efficiency for predicting GDM, with an area under the curve (AUC) of 0．986. When the cutoff value was set at 54．72 pg/mL, the sensitivity and specificity were 90．00% and 100．00%, respectively, with a Youden index of 0．950. Conclusion The occurrence of GDM is significantly associated with serum Lipin1 and adiponectin concentrations. Among these, Lipin1 levels are positively correlated with adiponectin and negatively correlated with leptin, demonstrating significant predictive value for GDM.

关键词

妊娠期糖尿病 / 妊娠早期 / 脂素蛋白1 / 瘦素 / 脂联素 / 糖脂代谢

Key words

gestational diabetes mellitus / early pregnancy / lipin1 / leptin / adiponectin / glucose and lipid metabolism

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基金资助

湖北省十堰市科技局引导性项目(19Y90)

湖北医药学院附属国药东风总医院院内硕导项目(2021S08)