妊娠期糖尿病病人血清25(OH)D、FGF19表达水平与分娩结局的关系研究

赵雪莲; 杨青; 张丽杰; 李亚男; 单爽; 王金玲

妊娠期糖尿病病人血清25(OH)D、FGF19表达水平与分娩结局的关系研究

Study on the relationship between the expression levels of serum 25(OH)D, FGF19 and delivery outcome in patients with gestational diabetes mellitus

摘要

摘要:
目的： 探究妊娠期糖尿病（GDM）病人血清25-羟维生素D 25(OH)D、成纤维细胞生长因子19（FGF19）的表达水平与分娩结局的关系。
方法： 选取我院妇产科2021年1月 ~ 2022年1月住院并生产的98例GDM病人设为研究组，同期选择90例来我院产检并分娩的健康妊娠妇女为对照组，比较2组临床相关资料，采用葡萄糖氧化酶法检测空腹血糖（FPG）、餐后2 h血糖（2 h PG）水平，采用酶联免疫吸附实验（ELISA）检测血清25(OH)D、FGF19水平。根据是否发生不良分娩结局将研究组分为不良结局组（22例）和结局良好组（76例），logistic回归模型分析不良分娩结局的相关影响因素，受试者工作特征（ROC）曲线分析血清25(OH)D、FGF19水平对GDM病人发生不良分娩结局的预测价值。
结果： 与对照组相比，研究组血清25(OH)D、FGF19水平降低（P ＜ 0.05），FPG、2h PG升高（P ＜ 0.05）；与结局良好组相比，不良结局组病人血清25(OH)D、FGF19水平均降低（P ＜ 0.05）。logistic回归分析显示，血清25(OH)D、FGF19水平是GDM孕妇分娩结局的保护性因素（P ＜ 0.05）。血清25(OH)D、FGF19预测GDM病人分娩结局的曲线下面积分别为0.955、0.892；截断值分别为37.35 nmol/L、95.60 ng/L；灵敏度为81.82%、72.73%；特异度分别为96.05%、93.42%。血清25(OH)D、FGF19水平联合预测GDM病人分娩结局的AUC为0.977，灵敏度为95.45%，特异度为92.11%。
结论： GDM病人血清25(OH)D、FGF19水平降低，均与分娩结局密切相关。

Abstract:
Objective To investigate the relationship between the expression levels of serum 25 hydroxyvitamin D (25(OH)D), fibroblast growth factor 19 (FGF19) and delivery outcome in patients with gestational diabetes mellitus (GDM).
Methods A total of 98 GDM patients hospitalized and delivered in our hospital from January 2021 to January 2022 were regarded as the study group, and 90 healthy pregnant women who came to our hospital for prenatal examination and delivery were included as the control group at the same time, and the general data of the two groups were compared. Fasting blood glucose (FPG) and 2h postprandial blood glucose (2h PG) were measured by glucose oxidase method. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum 25(OH)D and FGF19 in the two groups. The study group was divided into poor outcome group (22 cases) and good outcome group (76 cases) according to whether there was adverse delivery outcome, logistic regression model was used to analyze the related influencing factors of adverse delivery outcome, the predictive value of serum 25(OH)D and FGF19 levels for adverse delivery outcomes in GDM patients was analyzed by ROC curve.
Results Compared with the control group, the serum levels of 25 (OH) D and FGF19 in the study group decreased (P ＜ 0.05), while FPG and 2-hour PG increased (P ＜ 0.05). Compared with the group with good outcomes, the serum levels of 25 (OH) D and FGF19 in the group with poor outcomes decreased (P ＜ 0.05). Logistic regression analysis showed that serum 25(OH)D and FGF19 levels were protective factors for the delivery outcome of GDM pregnant women (P ＜ 0.05). The area under the curve of serum 25(OH)D and FGF19 in predicting the delivery outcome of GDM patients was 0.955 and 0.892, respectively. The truncation value was 37.35 nmol/L and 95.60 ng/L, respectively. The sensitivity was 81.82% and 72.73%, respectively. The specificity was 96.05% and 93.42%, respectively. The AUC of serum 25(OH)D combined FGF19 levels to predict the delivery outcome of GDM patients was 0.977, the sensitivity was 95.45%, and the specificity was 92.11%.
Conclusion The levels of serum 25(OH)D and FGF19 in GDM patients are decreased, and they are closely related to the delivery outcome.

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