[1]崔 蕾,高丽丽,孙志华,等.孕早期妇女血清C18∶1-Cer 和LPC18∶0 水平检测对妊娠期糖尿病的预测价值研究[J].现代检验医学杂志,2024,39(02):103-107+145.[doi:10.3969/j.issn.1671-7414.2024.02.019]
　CUI Lei,GAO Lili,SUN Zhihua,et al.Predictive Value of Serum C18∶1 -Cer and LPC18∶0 Levels in Early Pregnancy Women for Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2024,39(02):103-107+145.[doi:10.3969/j.issn.1671-7414.2024.02.019]
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孕早期妇女血清C18∶1-Cer 和LPC18∶0 水平检测对妊娠期糖尿病的预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年02期
页码:
103-107+145
栏目:
论著
出版日期:
2024-03-31

文章信息/Info

Title:
Predictive Value of Serum C18∶1 -Cer and LPC18∶0 Levels in Early Pregnancy Women for Gestational Diabetes Mellitus
文章编号:
1671-7414（2024）02-103-06
作者:
崔 蕾1; 高丽丽1; 孙志华1; 王 瑛1; 龚丽云2; 任 虹1
（1. 北京市朝阳区妇幼保健院妇产科，北京100020；2. 北京市朝阳医院产科，北京 100020）
Author(s):
CUI Lei1;  GAO Lili1;  SUN Zhihua1;  WANG Ying1;  GONG Liyun2;  REN Hong1
（1. Department of Obstetrics and Gynecology, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing 100020, China; 2. Department of Obstetrics, Beijing Chaoyang Hospital, Beijing 100020, China）
关键词:
血清十八碳一不饱和脂肪酸硬脂酰鞘氨醇; 血清1- 硬脂酰-sn- 甘油-3- 磷酰胆碱; 妊娠期糖尿病; 预测效能
分类号:
R714.256；R446.11
DOI:
10.3969/j.issn.1671-7414.2024.02.019
文献标志码:
A
摘要:
目的　探究孕妇孕期血清样本中血清十八碳一不饱和脂肪酸硬脂酰鞘氨醇（serum stearoyl sphingosine，C18∶1-Cer）和1- 硬脂酰基-sn- 甘油-3- 磷酸胆碱（lysophosphatidyl choline，LPC18∶0）水平在预测孕妇患妊娠期糖尿病（gestational diabetes mellitus，GDM）方面的价值。方法　回顾性分析126 例孕妇的临床资料和实验室指标，根据GDM 诊断结果，将研究对象分为GDM 组（n=66）和对照组（n=60）。采用质谱法检测研究对象孕早期和孕中期血清C18∶1-Cer 和LPC18∶0 水平，通过Logistic 回归分析筛选出GDM 的危险因素，采用受试者工作特征（receiveroperating characteristic，ROC）曲线评估C18∶1-Cer，LPC188∶0 和两者联合对GDM 的预测价值。结果　与对照组相比，GDM 组血清C18∶1-Cer 和LPC18∶0 水平在孕早期（18.92 ± 2.77ng/ml vs 23.47 ± 4.18ng/ml，41.32 ± 17.55ng/ml vs88.08 ± 16.02ng/ml）和孕中期（23.14 ± 4.10ng/ml vs 18.76 ± 4.05ng/ml，84.60 ± 14.53ng/ml vs 40.50 ± 17.79ng/ml）均显著升高，差异具有统计学意义（t=7.127，15.637；-5.984，2.174，均P ＜ 0.05）。C18∶1-Cer 与空腹血糖（fasting plasmaglucose，FPG）、空腹胰岛素（fasting plasma insulin，FPI）、胰岛素抵抗指数（homeostasis model assessment of insulinresistance，HOMA-IR）、糖化血红蛋白（glycated hemoglobin，HbA1c）和三酰甘油（triglyceride，TG）呈正相关（r=0.458，0.209，0.317，0.223，0.219，均P ＜ 0.05）。LPC18∶0 与FPG，FPI，HOMA-IR，HbA1c，总胆固醇（total cholesterol，TC）和TG 呈正相关（r=0.715，0.426，0.580，0.465，0.232，0.372，均P ＜ 0.05）。Logistic 回归分析结果显示，C18∶1-Cer[OR（95%CI）：1.522（1.136 ～ .039），P ＜ 0.05] 和LPC18∶0[OR（95%CI）：1.198（1.102 ～ 1.302），P ＜ 0.001]是GDM 的独立危险因素。ROC 曲线分析结果显示，血清C18∶1-Cer，LPC18∶0 和两指标联合的曲线下面积（areaunder the curve，AUC）分别为0.819，0.971 和0.986，两者联合检测的预测效能优于单独检测。结论　妊娠早期血清中的C18∶1-Cer 和LPC18∶0 与GDM 的发生密切相关，C18∶1-Cer 联合LPC18∶0 对GDM 早期诊断有一定的预测价值。
Abstract:
Objective To explore the value of serum stearoyl sphingosine (C18∶1-Cer) and 1-stearoyl-sn-glycero-3-phosphocholine (LPC 18 ∶ 0) levels in pregnant women’s serum samples during pregnancy in predicting gestational diabetes mellitus (GDM). Methods The clinical data and laboratory indicators of 126 pregnant women were retrospectively analyzed. The subjects were divided into GDM group（n=66） and control group（n=60） according to the GDM diagnosis results. Mass spectrometry was used to detect the serum C18∶1-Cer and LPC18∶0 levels of the subjects in early and mid pregnancy. Logistic regression analysis was used to screen out the risk factors for GDM. Receiver operating characteristic(ROC) curve was used to evaluate the predictive value of C18∶1-Cer, LPC18∶0 and their combination for GDM. Results Compared with the control group, the serum C18 ∶ 1-Cer and LPC18 ∶ 0 levels of the subjects in the GDM group were significantly increased in early (18.92±2.77ng/ml vs 23.47±4.18ng/ml, 41.32±17.55ng/ml vs 88.08±16.02ng/ml) and mid pregnancy (23.14±4.10ng/ml vs 18.76±4.05ng/ml, 84.60±14.53ng/ml vs 40.50±17.79ng/ml)，and the differences were statistically significant(t=7.127, 15.637; -5.984, 2.174, all P ＜ 0.05) C18∶1-Cer was positively correlated with fasting plasma glucose (FPG), fasting plasma insulin (FPI), homeostasis model assessment of insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c) and triglyceride (TG) (r=0.458，0.209，0.317，0.223，0.219，all P<0.05). LPC18.0 was positively correlated with FPG，FPI，HOMA-IR， HbA1c，total cholesterol (TC) and TG (r= 0.715，0.426，0.580，0.465，0.232，0.372，all P<0.05). Logistic regression analysis results showed that C18∶1-Cer [OR (95% CI): 1.522 (1.136 ～ 2.039)，P <0.05] and LPC18:0 [OR (95% CI): 1.198 (1.102 ～ 1.302)，P < 0.001] were independent risk factors for GDM. ROC curve analysis results showed that the area under the curve (AUC) of serum C18 ∶ 1-Cer, LPC18 ∶ 0 and the combination of the two indicators were 0.819, 0.971 and 0.986, respectively. The predictive performance of the combination of the two indicators was better than that of the single detection. Conclusion Serum C18∶1-Cer and LPC18∶0 in early pregnancy were closely related to the occurrence of GDM. C18∶1-Cer combined with LPC 18∶0 has a certain predictive value for the early diagnosis of GDM.

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备注/Memo

备注/Memo:
基金项目： 北京市教育委员会科技计划项目（KM201910025024）：妊娠期糖尿病患者血清脂质代谢组学特征及其在产后2 型糖尿病风险预测中的应用。
作者简介：崔蕾（1981-），女，硕士，主治医师，研究方向：妇科产科相关疾病，E-mail：hello_cuilei@126.com。
通讯作者：任虹（1971-），女，硕士，副主任医师，研究方向：妇科产科相关疾病，E-mail：843051250@qq.com。
更新日期/Last Update: 2024-03-15