文献类型：期刊文献

中文题名：妊娠期糖尿病患者血清载脂蛋白C3脂蛋白酯酶补体C1q/肿瘤坏死因子相关蛋白12水平与疾病进展的关系及诊断价值分析

英文题名：Analysis on the relationships between serum apolipoprotein C3,lipoprotein esterase,complement C1q/tumor necrosis factor-related protein 12 levels and disease progression in gestational diabetes mellitus patients and their diagnostic value

作者：王琼[1];王保平[2];张扬[1];王玮[3];尚蓝天[1];柴小丽[1];安勇[1]

第一作者：王琼

机构：[1]平凉市妇幼保健院,甘肃平凉744000;[2]甘肃医学院;[3]甘肃中医药大学附属医院妇产科

第一机构：平凉市妇幼保健院,甘肃平凉744000

年份：2025

卷号：40

期号：24

起止页码：4463

中文期刊名：中国妇幼保健

外文期刊名：Maternal and Child Health Care of China

基金：陇原青年创新创业人才项目(甘组通字[2023]20号);甘肃省中医药科研课题(GZKP-2023-17);甘肃省平凉市科技计划项目(PL-STK-2023A-033);甘肃省高等学校创新基金项目(2021A-183)。

语种：中文

中文关键词：妊娠期糖尿病;载脂蛋白C3;脂蛋白酯酶;补体C1q/肿瘤坏死因子相关蛋白12;诊断价值

外文关键词：Gestational diabetes mellitus;Apolipoprotein C3;Lipoprotein esterase;Complement C1q/tumor necrosis factor-related protein 12;Diagnostic value

摘要：目的分析妊娠期糖尿病(GDM)患者血清载脂蛋白C3(ApoC3)、脂蛋白酯酶(LPL)、补体C1q/肿瘤坏死因子相关蛋白12(CTRP12)水平与疾病进展的关系及诊断价值。方法选取2021年6月—2023年6月在平凉市妇幼保健院接受治疗的145例GDM患者为GDM组,接受产前检查的132例孕妇为对照组。比较两组血清ApoC3、LPL、CTRP12水平。采用Spearman相关性分析法分析ApoC3、LPL、CTRP12与空腹血糖(FPG)、口服葡萄糖耐量试验(OGTT)-空腹血糖、OGTT-1 h血糖、OGTT-2 h血糖的关系。采用多因素logistic回归模型分析GDM发生的影响因素。绘制受试者工作特征(ROC)曲线,评估ApoC3、LPL、CTRP12对GDM的诊断价值。结果GDM组与对照组的年龄、孕前体质指数(BMI)、孕早期FPG、孕早期三酰甘油(TG)水平比较差异均有统计学意义(均P<0.05)。对照组血清ApoC3水平为(166.61±36.98)mg/L,LPL水平为(43.22±12.82)μg/L,CTRP12水平为(8.01±2.70)ng/ml;GDM组血清ApoC3水平为(203.96±45.89)mg/L,LPL水平为(27.54±11.14)μg/L,CTRP12水平为(6.64±1.66)ng/ml。GDM组血清ApoC3水平高于对照组,LPL、CTRP12水平均低于对照组(均P<0.05)。GDM组OGTT-空腹血糖、OGTT-1 h血糖、OGTT-2 h血糖水平均高于对照组(均P<0.05)。Spearman相关性分析显示:血清ApoC3水平与FPG、OGTT-空腹血糖、OGTT-1 h血糖、OGTT-2 h血糖水平均呈正相关(均P<0.05);血清LPL、CTRP12水平与FPG、OGTT-空腹血糖、OGTT-1 h血糖、OGTT-2 h血糖水平均呈负相关(均P<0.05)。多因素logistic回归分析显示:年龄、ApoC3、LPL、CTRP12、FPG、孕前BMI、孕早期TG均为发生GDM的影响因素(均P<0.05)。血清ApoC3、LPL、CTRP12联合诊断GDM的曲线下面积(AUC)为0.882(95%CI:0.844~0.920),灵敏度为73.80%,特异度为86.40%。ApoC3、LPL、CTRP12联合诊断的AUC显著大于三者单独诊断(均P<0.05)。结论GDM患者血清ApoC3水平升高,血清LPL、CTRP12水平降低,三者与GDM患者疾病进展密切相关,能够有效评估GDM患者的疾病严重性。ApoC3、LPL、CTRP12联合检测在GDM诊断中具有较高价值。
Objective To analyze the relationships between serum apolipoprotein C3(ApoC3),lipoprotein esterase(LPL),complement C1q/tumor necrosis factor-related protein 12(CTRP12)levels and disease progression in patients with gestational diabetes mellitus(GDM)and their diagnostic value.Methods A total of 145 GDM patients who were treated in Pingliang Maternal and Child Health Hospital from June 2021 to June 2023 were selected as GDM group,and 132 pregnant women who received prenatal examination were selected as control group.The levels of serum ApoC3,LPL,and CTRP12 were compared between the two groups.Spearman correlation analysis was used to analyze the relationships between ApoC3,LPL,CTRP12 and fasting plasma glucose(FPG),oral glucose tolerance test(OGTT)-fasting blood glucose,OGTT-1 h blood glucose,OGTT-2 h blood glucose.Multivariate logistic regression model was used to analyze the influencing factors of GDM.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of ApoC3,LPL,and CTRP12 for GDM.Results There were statistically significant differences in age,pre-pregnancy body mass index(BMI),FPG,and triglyceride(TG)levels in early pregnancy between GDM group and control group(all P<0.05).In control group,serum ApoC3 level was(166.61±36.98)mg/L,LPL level was(43.22±12.82)μg/L,and CTRP12 level was(8.01±2.70)ng/ml;in GDM group,serum levels of ApoC3,LPL,and CTRP12 were(203.96±45.89)mg/L,(27.54±11.14)μg/L,and(6.64±1.66)ng/ml,respectively.The level of serum ApoC3 in GDM group was higher than that in control group,and the levels of LPL and CTRP12 were lower than those in control group(all P<0.05).The levels of OGTT-fasting blood glucose,OGTT-1 h blood glucose,and OGTT-2 h blood glucose in GDM group were higher than those in control group(all P<0.05).Spearman correlation analysis showed that serum ApoC3 level was positively correlated with FPG,OGTT-fasting blood glucose,OGTT-1 h blood glucose,and OGTT-2 h blood glucose(all P<0.05).Serum LPL and CTRP12 levels were negatively correlated with FPG,OGTT-fasting blood glucose,OGTT-1 h blood glucose,and OGTT-2 h blood glucose levels(all P<0.05).Multivariate logistic regression analysis showed that age,ApoC3,LPL,CTRP12,FPG,pre-pregnancy BMI,and TG in early pregnancy were the influencing factors of GDM(all P<0.05).The area under the curve(AUC)of combined diagnosis of GDM by serum ApoC3,LPL,and CTRP12 was 0.882(95%CI:0.844-0.920),the sensitivity was 73.80%,and the specificity was 86.40%.AUC of combined diagnosis of ApoC3,LPL,and CTRP12 was significantly larger than that of single diagnosis(all P<0.05).Conclusion The level of serum ApoC3 in GDM patients increases,and the levels of serum LPL and CTRP12 decrease.The three indexes are closely related to disease progression of GDM patients,which can effectively evaluate the severity of GDM patients.The combined detection of ApoC3,LPL,and CTRP12 has high value in diagnosis of GDM.