妊娠早期血清过氧化物还原酶4对妊娠糖尿病的风险预测价值分析
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中图分类号：R714.2 文献标志码：A DOI：10.11958/20252188
Analysis of the predictive value of serum peroxiredoxin 4 in early pregnancy for the risk of gestational diabetes
WU Huan，ZHUANG YingΔ ，ZHOU Min，PENG Ziping，YUChan DepartmentofObstetricsandGynecology，Shanghai First Maternal andChild HealthCareHospital/Obstetricsand Gynecology Hospital ofTongji University，Shanghai 2Ooo4O， China Corresponding Author E -mail： zhuangying@51mch.com
Abstract：ObjectiveToinvestigatechangesofserumperoxiredoxin4levelinpatients withgestationaldiabetesmellitus （GDM）attheearlystageanditsdiagnosticvalueforGDM.MethodsAtotalof372earlypregantwomenwhovisitedourospital fromMarch 2021toMay2O24 were selectedasthe studysubjects.Thediagnosis ofGDMwas determined basedontheresults of the oral glucose tolerance test （OGTT）.Pregnant women were divided into the GDM group （ n =89）and the control group（ n =283）. Clinical data，lboratoryindicatorsandlevelsofperoxiredoxin4werecomparedbetweentworoupsofpatients.Thecoraion between serum peroxiredoxin4levels andlaboratory indicators was analyzed.Risk factors for theoccuenceof GDMand its diagnosticefcacyforGDMwerealsoanalyzed.ResultsTheproportionoffamilyhistoryofdiabetes，insulinresistanceindex （HOMA-IR），fsingplasma glucose （FPG），postprandial1hlucose（1G），postprandial2hglucose （2G），C-peptded serum peroxidase reductase 4 were higher in the GDM group than those in the control group （ P<0.05 ），while the pancreatic β -cell function index （HOMA- ⋅β ） was lower in the GDM group than those in the control group （ P<0.05 ）. The level of serum peroxidase reductase 4 was positivelycorelated with HOMA-IR，FPG，1hPG，2 hPGand C-peptidein the GDM group，and which was negativelycorrelated withHOMA- β 0 P<0.05 ）.Multifactorial Logistic regressionanalysis showed that elevatedHOMA-IR，FPG， 1 hPG，2 hPG，C-peptide and peroxidase reductase 4were risk factors for the occurrnce of GDM，while elevated HOMA- ⋅β was theprotective factor for the occurrence of GDM（ P<0.05 ）.The area under the curve （AUC）for peroxidase reductase 4 in diagnosing GDMwas0.912（ 95% CI： 0.871-0.953），with a sensitivity of 79.79% and specificity of 89.36% when the optimal cutoff value was 0.93 U/L.ConclusionTheserumlevelofperoxiredoxin4inGDMpatientsissignificantlyelevated，showinggooddiagostic efficacy for GDM.
Key Words： diabetes，gestational; peroxiredoxin II; insulin resistance; Logistic models; ROC curve
妊娠糖尿病（gestational diabetesmellitus，GDM）是指在妊娠期间首次出现的糖尿病[1]，具有较高的发生率，与多种不良妊娠结局相关，如胎儿巨大、早产等，且存在孕妇发展为2型糖尿病的风险[2-3]GDM的发病机制尚未完全明确，但越来越多的研究表明，氧化应激在GDM的发生和发展中起着重要作用[4]。（剩余8968字）
