| 吴亚南,刘雅琴,范 蕾,刘芳玲,孙晓庆,李明月.血清CREB、FoxO1、NLRP3与妊娠期糖尿病患者胰岛素抵抗的相关性分析及对妊娠结局的影响[J].,2023,(20):3950-3954 |
| 血清CREB、FoxO1、NLRP3与妊娠期糖尿病患者胰岛素抵抗的相关性分析及对妊娠结局的影响 |
| Analysis of the Correlation between Serum CREB, FoxO1 and NLRP3 and Insulin Resistance in Patients with Gestational Diabetes Mellitus and the Effect on Pregnancy Outcome |
| 投稿时间：2023-03-07 修订日期：2023-03-31 |
| DOI：10.13241/j.cnki.pmb.2023.20.030 |
| 中文关键词: 妊娠期糖尿病 CREB FoxO1 NLRP3 胰岛素抵抗 妊娠结局 |
| 英文关键词: Gestational diabetes mellitus CREB FoxO1 NLRP3 Insulin resistance Pregnancy outcome |
| 基金项目:湖南省临床医疗技术创新引导项目（2021SK52102） |
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| 中文摘要: |
| 摘要 目的：探讨血清环磷腺苷效应元件结合蛋白（CREB）、叉头框蛋白O1（FoxO1）、NOD样受体热蛋白结构域相关蛋白3（NLRP3）与妊娠期糖尿病（GDM）患者胰岛素抵抗（IR）的相关性分析及对妊娠结局的影响。方法：选取2019年12月～2022年8月邵阳学院附属第一医院收治的136例GDM患者为GDM组，根据妊娠结局分为结局不良组（42例）和结局良好组（94例），另选取55名健康孕妇为对照组。收集GDM患者临床资料，检测血清CREB、FoxO1、NLRP3水平并计算稳态模型评估-胰岛素抵抗（HOMA-IR）。采用Pearson相关性分析GDM患者血清CREB、FoxO1、NLRP3水平与HOMA-IR的相关性，多因素Logistic回归分析GDM患者妊娠结局不良的影响因素，受试者工作特征（ROC）曲线分析血清CREB、FoxO1、NLRP3水平对GDM患者妊娠结局不良的预测价值。结果：与对照组比较，GDM组血清CREB、FoxO1、NLRP3水平和HOMA-IR升高（P＜0.05）。Pearson相关性分析显示，GDM患者血清CREB、FoxO1、NLRP3水平与HOMA-IR呈正相关（P均＜0.001）。136例GDM患者妊娠结局不良发生率为30.88%。多因素Logistic回归分析显示，HOMA-IR、CREB、FoxO1、NLRP3升高为GDM患者妊娠结局不良的危险因素（P＜0.05）。ROC曲线分析显示，血清CREB、FoxO1、NLRP3水平联合预测GDM患者妊娠结局不良的曲线下面积大于CREB、FoxO1、NLRP3单独预测。结论：血清CREB、FoxO1、NLRP3水平升高与GDM患者IR和妊娠结局不良密切相关，可能成为GDM患者妊娠结局不良的辅助预测指标。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation analysis of serum cAMP-response element binding protein (CREB), forkhead Box O1 (FoxO1), NOD-like receptor pyrin domain containing 3 (NLRP3) and insulin resistance (IR) in patients with gestational diabetes mellitus (GDM) and their effects on pregnancy outcome. Methods: 136 patients with GDM who were admitted to the First Affiliated Hospital of Shaoyang University from December 2019 to August 2022 were selected as the GDM group. According to the pregnancy outcome, they were divided into poor outcome group (42 cases) and good outcome group (94 cases), and 55 healthy pregnant women were selected as the control group. Clinical data of patients with GDM were collected, serum CREB, FoxO1 and NLRP3 levels were detected, and homeostasis model assessment - Insulin resistance (HOMA-IR) was calculated. Pearson was used to analyze the correlation between serum CREB, FoxO1 and NLRP3 levels and HOMA-IR in patients with GDM, and multivariate Logistic regression was used to analyze the influencing factors of poor pregnancy outcomes in patients with GDM. The predictive value of serum CREB, FoxO1 and NLRP3 levels for adverse pregnancy outcomes in patients with GDM was analyzed by receiver operating characteristic (ROC) curve. Results: Compared with the control group, serum CREB, FoxO1, NLRP3 levels and HOMA-IR in the GDM group elevated (P＜0.05). Pearson correlation analysis showed that serum CREB, FoxO1 and NLRP3 levels in patients with GDM were positively correlated with HOMA-IR (all P＜0.001). The incidence of poor pregnancy outcomes in 136 patients with GDM was 30.88%. Multivariate Logistic regression analysis showed that elevated HOMA-IR, CREB, FoxO1 and NLRP3 were the risk factors for poor pregnancy outcomes in patients with GDM (P＜0.05). ROC curve analysis showed that the combined prediction of serum CREB, FoxO1 and NLRP3 levels for poor pregnancy outcomes in patients with GDM was greater than that of CREB, FoxO1 and NLRP3 alone. Conclusion: Elevated serum CREB, FoxO1 and NLRP3 levels are closely related to IR and poor pregnancy outcomes in patients with GDM, which may be the auxiliary predictors of poor pregnancy outcomes in patients with GDM. |
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