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中华肥胖与代谢病电子杂志 ›› 2020, Vol. 06 ›› Issue (03) : 159 -164. doi: 10.3877/cma.j.issn.2095-9605.2020.03.004

所属专题： 专题评论； 文献；

论著

孕中期血清锌-α2-糖蛋白水平与妊娠期糖尿病关联性评价
苏红莉1, 陈桂霞1, 张丽1, 徐冬梅1,†()   
  1. 1. 450052　郑州，郑州大学第三附属医院孕产保健部
  • 收稿日期:2020-01-08 出版日期:2020-08-30
  • 通信作者: 徐冬梅

Relevance evaluation between serum zinc -alpha 2-glycoprotein levels in mid pregnancy and gestational diabetes

Hongli Su1, Guixia Chen1, Li Zhang1, Dongmei Xu1,†()   

  1. 1. Department of Maternity And Health Care of the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
  • Received:2020-01-08 Published:2020-08-30
  • Corresponding author: Dongmei Xu
  • About author:
    Corresponding auther: Xu Dongmei, Email:
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苏红莉, 陈桂霞, 张丽, 徐冬梅. 孕中期血清锌-α2-糖蛋白水平与妊娠期糖尿病关联性评价[J]. 中华肥胖与代谢病电子杂志, 2020, 06(03): 159-164.

Hongli Su, Guixia Chen, Li Zhang, Dongmei Xu. Relevance evaluation between serum zinc -alpha 2-glycoprotein levels in mid pregnancy and gestational diabetes[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2020, 06(03): 159-164.

目的

探讨妊娠期糖尿病（GDM）患者血清中锌-α2-糖蛋白（ZAG）蛋白表达水平，以及其与孕期临床指标对GDM的预测作用。

方法

选取2018年7月至2019年4月在郑州大学第三附属医院进行产检的GDM患者42例纳入GDM组，同期42例健康孕妇为对照组，收集其孕24~28周行75 g葡萄糖耐量试验时空腹血清，用酶联免疫吸附法（ELISA）检测两组血清ZAG水平及回顾性收集和分析其基线资料、孕期生化指标，采用配对t检验，Mann-Whitney u检验进行组间比较，采用logistic回归分析各指标与患病之间的联系；ROC曲线则用于各指标的预测。

结果

GDM组孕前体质量指数（BMI）、孕早期空腹血糖（FPG）、甘油三酯（TG）高于对照组，血清ZAG水平低于对照组，差异具有统计学意义（P<0.05）；多因素logistic回归分析显示：孕早期空腹血糖（FPG）、年龄是GDM发生的危险因素，ZAG为GDM发生的保护因素；ROC曲线分析各项指标显示ZAG对GDM有预测价值（P<0.05）。

结论

GDM组血清中ZAG水平显著低于对照组，ZAG可能参与了GDM的发生与发展，有望作为一个新的高特异度指标用于GDM的诊断。

关键词: 妊娠期糖尿病, 锌-α2-糖蛋白, 血脂代谢
Objective

To investigate the expression level of serum ZAG protein in patients with gestational diabetes mellitus and the predictive effect of ZAG protein and early Pregnancy index on GDM.

Methods

42 patients with gestational diabetes mellitus who were examined in the third affiliated Hospital of Zhengzhou University from July 2018 to April 2019 were included in the GDM group, and 42 healthy pregnant women were treated as control group in the same period, and 24-28 weeks of OGTT spatiotemporal abdominal serum were collected. The serum ZAG levels of the two groups were detected by enzyme-linked immunosorbent method (ELISA) and compared, and the baseline data and early biochemical indexes of pregnancy were collected and analyzed retrospectively. Using a paired T-test, Mann-Whitney U test group comparison, using logistic regression to analyze the link between indicators and disease.

Results

The expression level of serum ZAG protein in the GDM group was lower than that in control group, pre-pregnancy BMI, early pregnancy fasting blood glucose(FPG) and triglycerides (TG) were higher in the GDM group than in the control group, and all the difference were statistically significant (P<0.05), and logistic regression analysis showed that FPG ,age ,were Increases the incidence of GDM; ZAG is an independent protective factor for GDM. ROC curve analysis indicators showed ZAG is the predictive abilities (P<0.05) for GDM.

Conclusions

The expression level of ZAG in the serum of the GDM group is significantly lower than that in the control group, and ZAG may be involved in the occurrence and development of GDM, which is expected to be used as a new high specificity index for the clinical diagnosis of GDM.

Key words: Gestational diabetes mellitus, Zinc-α2-Glycoprotein, lipid metabolism
表1 GDM组与对照组基线资料之间的比较
? GDM组（n=42） 对照组（n=42） t/Z P值
年龄（岁） 31.00±4.22 29.02 ± 3.69 1.447 0.152
孕前BMI（kg/m2） 22.58±3.12 20.99 ± 2.47 2.674 0.011*
孕次 2（1,2） 2（1.00, 2.50） -0.073 0.942
产次 0（0, 1） 0（0, 1） -0.447 0.655
表2 GDM组与对照组孕早期生化指标的比较
? GDM组（n=42） 对照组（n=42） t/Z P值
FPG（mmol/L） 4.83（4.59,5.16） 4.68（4.62,4.68） -2.821 0.005*
TG（mmol/L） 1.44±0.69 1.14±0.42 -2.458 0.018*
TC（mmol/L） 4.45±0.74 4.57±0.67 0.732 0.468
HDL-C（mmol/L） 1.54±0.25 1.57±0.28 0.481 0.633
LDL-C（mmol/L） 2.46±0.53 2.48±0.46 0.221 0.827
表3 GDM组与对照组孕中期生化指标的比较
? GDM组（n=42） 对照组（n=42） t/Z P值
ZAG（μg/mL） 35.40（27.96,44.68） 45.34（33.11,63.99） -3.240 <0.001*
OGTT（0h）（mmol/L） 5.13 ± 0.49 4.52 ± 0.32 -6.048 <0.001**
OGTT（1h）（mmol/L） 9.34 ± 1.77 6.75 ± 1.23 -7.362 <0.001**
OGTT（2h）（mmol/L） 8.09 ± 1.38 6.23 ± 0.98 -7.352 <0.001**
表4 排除混杂因素后GDM患者多因素logistic回归分析结果
变量 B 标准误 Wald值 P值 OR值 95% CI
孕中期ZAG -0.39 0.015 6.476 0.011* 0.962 （0.934, 0.991）
表5 GDM患者多因素logistic回归分析结果
变量 B 标准误 Wald值 P值 OR值 95% CI
ZAG -0.39 0.015 6.476 0.029* 0.972 （0.948, 0.997）
FPG 2.527 0.816 9.604 0.002* 12.520 （2.532, 61.909）
年龄 0.138 0.068 4.148 0.042* 1.148 （1.005, 1.311）
孕前BMI 0.121 0.101 1.446 0.229 1.129 （0.926, 1.376）
表6 血清中ZAG表达水平的ROC曲线分析结果
? 曲线下面积 标准误 P值 95% CI 临界值
ZAG 0.659 0.060 0.012* （0.541, 0.776） 44.16
图1 血清中ZAG表达水平的ROC曲线
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