分泌型卷曲相关蛋白5与妊娠期糖尿病患者产后糖代谢异常的关系研究

doi:10.11958/20220140

天津医药 ›› 2022, Vol. 50 ›› Issue (11): 1182-1185.doi: 10.11958/20220140

分泌型卷曲相关蛋白5与妊娠期糖尿病患者产后糖代谢异常的关系研究

杨冠兰¹(), 郑丹¹, 杨冠佼², 刘艳¹^,^△()

1 贵阳市妇幼保健院产科（邮编550003）
2 中医科

收稿日期:2022-01-23 修回日期:2022-04-02 出版日期:2022-11-15 发布日期:2022-11-11
通讯作者: 刘艳 E-mail:yanggl6521456@163.com;523201803@qq.com
作者简介:杨冠兰（1981），女，副主任医师，主要从事妇产科方面的研究。E-mail：yanggl6521456@163.com
基金资助:
贵州省卫生计生委科学技术基金项目(gzwjkj2018-1-080)

The relationship between secreted frizzled-related protein 5 and abnormal postpartum glucose metabolism in patients with gestational diabetes mellitus

YANG Guanlan¹(), ZHENG Dan¹, YANG Guanjiao², LIU Yan¹^,^△()

1 Department of Obstetrics, Guiyang 550003, China
2 Department of Traditional Chinese Medicine, Guiyang Maternal and Child Health Hospital, Guiyang 550003, China

Received:2022-01-23 Revised:2022-04-02 Published:2022-11-15 Online:2022-11-11
Contact: LIU Yan E-mail:yanggl6521456@163.com;523201803@qq.com

杨冠兰, 郑丹, 杨冠佼, 刘艳. 分泌型卷曲相关蛋白5与妊娠期糖尿病患者产后糖代谢异常的关系研究[J]. 天津医药, 2022, 50(11): 1182-1185.

YANG Guanlan, ZHENG Dan, YANG Guanjiao, LIU Yan. The relationship between secreted frizzled-related protein 5 and abnormal postpartum glucose metabolism in patients with gestational diabetes mellitus[J]. Tianjin Medical Journal, 2022, 50(11): 1182-1185.

摘要/Abstract

摘要：

目的分析分泌型卷曲相关蛋白5（SFRP5）与妊娠期糖尿病（GDM）患者产后糖代谢异常的关系。方法选取GDM患者238例，患者均于产后12周进行门诊复查，根据糖代谢情况分为糖代谢正常组和糖代谢异常组。收集所有患者的相关临床资料，采用酶联免疫吸附试验检测血清SFRP5水平。采用Logistic回归分析GDM患者产后糖代谢异常的危险因素。采用受试者工作特征（ROC）曲线分析相关指标对GDM患者产后糖代谢异常的预测价值。结果 238例GDM患者产后12周时糖代谢正常组192例，糖代谢异常组46例。糖代谢异常组的孕前体质量指数（BMI）、葡萄糖耐量试验（OGTT）1 h血糖均高于糖代谢正常组，血清SFRP5水平低于糖代谢正常组（P<0.05）。多因素Logistic回归分析显示，孕前BMI过高为GDM患者产后糖代谢异常的危险因素（OR=1.844，95%CI：1.099~3.094），而血清SFRP5水平升高则为GDM患者产后糖代谢异常的保护因素（OR=0.794，95%CI：0.645~0.977）。经ROC分析显示，孕前BMI及血清SFRP5预测GDM患者产后糖代谢异常的曲线下面积分别为0.727（95%CI：0.656~0.799）、0.715（95%CI：0.625~0.806），而两者联合使用后预测价值可得到进一步提升，ROC曲线下面积为0.809（95%CI：0.739~0.878）。结论血清SFRP5水平与GDM患者产后糖代谢异常情况密切相关，其与孕前BMI联合应用对患者产后糖代谢异常有一定的预测价值。

关键词: 糖尿病, 妊娠, 葡萄糖代谢障碍, 分泌型卷曲相关蛋白5, 产后

Abstract:

Objective To analyze the relationship between secreted frizzled-related protein 5 (SFRP5) and abnormal postpartum glucose metabolism in patients with gestational diabetes mellitus (GDM). Methods A total of 238 GDM patients were selected. All patients underwent outpatient reexamination at 12 weeks postpartum, and were divided into the normal glucose metabolism group and the abnormal glucose metabolism group according to their glucose metabolism. The relevant clinical data of all patients were collected, and the serum level of SFRP5 was detected by enzyme-linked immunosorbent assay. Logistic regression equation was used to analyze the risk factors of abnormal postpartum glucose metabolism in patients with GDM. Receiver operating characteristic curves (ROC) were used to analyze the predictive value of relevant indicators for postpartum glucose metabolism abnormalities in patients with GDM. Results Of the 238 GDM patients, 192 patients were in the normal glucose metabolism group and 46 patients were in the abnormal glucose metabolism group at 12 weeks postpartum. The pre-pregnancy body mass index (BMI) and the glucose tolerance test (OGTT) 1 h blood glucose were higher in the abnormal glucose metabolism group than those in the normal glucose metabolism group, and the serum SFRP5 level was lower than that in the normal glucose metabolism group (P<0.05). Multivariate Logistic regression analysis showed that high pre-pregnancy BMI (OR=1.844, 95%CI: 1.099-3.094) was a risk factor for postpartum abnormal glucose metabolism in GDM patients, while high serum SFRP5 level (OR=0.794, 95%CI: 0.645-0.977) was a protective factor for postpartum abnormal glucose metabolism in GDM patients (P<0.05). ROC analysis showed that the areas under the curve of progestational body mass index and serum SFRP5 in predicting postpartum glucose metabolism abnormalities in patients with GDM were 0.727 (95%CI: 0.656-0.799) and 0.715 (95%CI: 0.625-0.806), respectively. The predictive value could be further improved after the combination of the two, and the area under the curve of ROC was 0.809 (95%CI: 0.739-0.878). Conclusion Serum SFRP5 level is closely related to abnormal postpartum glucose metabolism in GDM patients, and its combined application with pre-pregnancy body mass index has certain predictive value for postpartum abnormal glucose metabolism.

Key words: diabetes, gestational, glucose metabolism disorders, secreted frizzled-related protein 5, postpartum

中图分类号:

R714.256

图/表 3

参考文献 19

[1]	JUAN J, YANG H. Prevalence,prevention,and lifestyle intervention of gestational diabetes mellitus in China[J]. Int J Environ Res Public Health, 2020, 17(24):9517. doi:10.3390/ijerph17249517.
[2]	GUILLÉN-SACOTO M A, BARQUIEL B, HILLMAN N, et al. Gestational diabetes mellitus: glycemic control during pregnancy and neonatal outcomes of twin and singleton pregnancies[J]. Endocrinol Diabetes Nutr(Engl Ed),2018, 65(6):319-327. doi:10.1016/j.endinu.2018.01.011.
[3]	DI CIANNI G, LACARIA E, LENCIONI C, et al. Preventing type 2 diabetes and cardiovascular disease in women with gestational diabetes-the evidence and potential strategies[J]. Diabetes Res Clin Pract, 2018, 145:184-192. doi:10.1016/j.diabres.2018.04.021.
[4]	LAI M, LIU Y, RONNETT G V, et al. Amino acid and lipid metabolism in post-gestational diabetes and progression to type 2 diabetes: A metabolic profiling study[J]. PLoS Med, 2020, 17(5):e1003112. doi:10.1371/journal.pmed.1003112.
[5]	YOU H, HU J, LIU Y, et al. Risk of type 2 diabetes mellitus after gestational diabetes mellitus: a systematic review & meta-analysis[J]. Indian J Med Res, 2021, 154(1):62-77. doi:10.4103/ijmr.IJMR_852_18.
[6]	孟莉. 妊娠期糖尿病患者外周血Sfrp5、FoxM1水平与胰岛素抵抗的关系[J]. 山东医药, 2017, 57(30):48-50.
	MENG L. Relationship between the levels of Sfrp5,FoxM1 in peripheral blood and insulin resistance in patients with gestational diabetes mellitus[J]. Shandong Med J, 2017, 57(30):48-50. doi:10.3969/j.issn.1002-266X.2017.30.014.
[7]	中华医学会妇产科学分会产科学组, 中华医学会围产医学分会妊娠合并糖尿病协作组. 妊娠合并糖尿病诊治指南(2014)[J]. 中华妇产科杂志, 2014, 49(8):561-569.
	Obstetrics Group, Obstetrics and Gynecology Branch of Chinese Medical Association,Pregnancy and Diabetes Collaborative Group of Perinatal Medicine Branch of Chinese Medical Association. Guidelines for diagnosis and treatment of pregnancy complicated with diabetes(2014)[J]. Chin J Obstet Gynecol, 2014, 49(8):561-569. doi:10.3760/cma.j.issn.0529-567x.2014.08.001.
[8]	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中国实用内科杂志, 2018, 38(4):292-344.
	Diabetes Branch of Chinese Medical Association. Guidelines for the prevention and control of type 2 diabetes in China(2017 Edition)[J]. Chinese Journal of Practical Internal Medicine, 2018, 38(4):292-344. doi:10.19538/j.nk2018040108.
[9]	BENHALIMA K, LENS K, BOSTEELS J, et al. The risk for glucose intolerance after gestational diabetes mellitus since the introduction of the IADPSG criteria:A systematic review and Meta-analysis[J]. J Clin Med, 2019, 8(9) doi:10.3390/jcm8091431.
[10]	American Diabetes Association. Improving care and promoting health in populations:Standards of medical care in diabetes-2020[J]. Diabetes Care, 2020, 43(Suppl 1):S7-S13. doi:10.2337/dc20-S001.
[11]	刘烨, 王海宁, 魏瑗, 等. 妊娠期糖尿病妇女产后糖代谢转归相关因素的前瞻性队列研究[J]. 中华糖尿病杂志, 2020, 12(10):814-818.
	LIU H, WANG H N, WEI Y, et al. Risk factors for glucose metabolism disorder at postpartum among women with gestational diabetes mellitus:A prospective cohort study[J]. Chinese Journal of Diabetes Mellitus, 2020, 12(10):814-818. doi:10.3760/cma.j.cn115791-20200120-00029.
[12]	陈青红, 杨琳琳. 妊娠糖尿病患者产后6-12周糖代谢转归及相关因素探讨[J]. 中华全科医学, 2021, 19(3):425-427,431.
	CHEN Q H, YANG L L. Study on the outcome of glucose metabolism and related factors in gestational diabetes mellituss at 6-12 weeks postpartum[J]. Chinese Journal of General Practice, 2021, 19(3):425-427,431. doi:10.16766/j.cnki.issn.1674-4152.001827.
[13]	RYDZEWSKA M, NIKOłAJUK A, MATULEWICZ N, et al. Serum secreted frizzled-related protein 5 in relation to insulin sensitivity and its regulation by insulin and free fatty acids[J]. Endocrine, 2021, 74(2):300-307. doi:10.1007/s12020-021-02793-z.
[14]	梁愿, 李章春, 王青, 等. 血清分泌型卷曲相关蛋白5与中老年2型糖尿病代谢综合征的相关性研究[J]. 现代医学, 2018, 46(6):629-632.
	LIANG Y, LI Z C, WANG Q, et al. Relationship of serum secreted frizzled-related protein-5 and elderly people type 2 diabetes mellitus metabolic syndrome[J]. Modern Medical Journal, 2018, 46(6):629-632. doi:10.3969/j.issn.1671-7562.2018.06.006.
[15]	朱伟, 郑世霞, 柯琳秋, 等. 分泌性卷曲相关蛋白5表达上调对小鼠肝脏糖代谢的影响[J]. 生命科学研究, 2017, 21(6):523-526.
	ZHU W, ZHENG S X, KE L Q, et al. Effects of over-expression of secreted frizzled-related protein 5(SFRP5)on glucose metabolism in mouse liver[J]. Life Science Research, 21(6):523-526.doi:10.16605/j.cnki.1007-7847.2017.06.010.
[16]	LIU L B, CHEN X D, ZHOU X Y, et al. The wnt antagonist and secreted frizzled-related protein 5: implications on lipid metabolism,inflammation,and type 2 diabetes mellitus[J]. Biosci Rep, 2018, 38(4):BSR20180011. doi:10.1042/BSR20180011.
[17]	WANG D, ZHANG Y, SHEN C. Research update on the association between SFRP5,an anti-inflammatory adipokine,with obesity,type 2 diabetes mellitus and coronary heart disease[J]. J Cell Mol Med, 2020, 24(5):2730-2735. doi:10.1111/jcmm.15023.
[18]	李根霞, 谢明坤, 郭淑华, 等. 脂肪因子分泌型卷曲相关蛋白5与超重肥胖及妊娠期糖尿病的相关性[J]. 中华围产医学杂志, 2018, 21(5):334-337.
	LI G X, XIE M K, GUO S H, et al. Correlation of adipokines-secreted frizzled-related protein 5 with overweight and obesity and gestational diabetes mellitus[J]. Chinese Journal of Perinatal Medicine, 2018, 21(5):334-337. doi:10.3760/cma.j.issn.1007-9408.2018.05.011.
[19]	KOUTAKI D, MICHOS A, BACOPOULOU F, et al. The emerging role of sfrp5 and wnt5a in the pathogenesis of obesity:implications for a healthy diet and lifestyle[J]. Nutrients, 2021, 13(7):2459. doi:10.3390/nu13072459.

组别	n		年龄（岁）		孕前BMI （kg/m²）	糖尿病家族史	产次（次）		孕期使用胰岛素		新生儿体质量（g）		FBG （mmol/L）		OGTT 1 h血糖（mmol/L）
糖代谢正常组	192		29.24±5.23		23.02±3.16	71（36.98）	1.62±0.35		16（8.33）		3 215.48±504.19		5.08±0.43		9.91±1.26
糖代谢异常组	46		30.12±4.87		24.78±2.28	20（43.48）	1.71±0.26		8（17.39）		3 301.52±315.73		5.16±0.38		10.32±1.12
t或χ²			1.038		3.559^＊＊	0.664	1.638		2.433		1.016		1.158		2.023^＊
组别		OGTT 2 h血糖（mmol/L）		FINS （mIU/L）		收缩压（mmHg）		舒张压（mmHg）		总胆固醇（mmol/L）		LDL-C （mmol/L）		三酰甘油（mmol/L）		SFRP5 （μg/L）
糖代谢正常组		8.73±0.85		14.36±2.59		124.52±13.75		80.69±9.21		5.01±0.84		3.02±0.98		1.87±0.48		2.99±1.03
糖代谢异常组		8.97±0.63		15.03±2.18		127.48±10.36		81.27±7.33		5.12±0.53		3.14±0.69		1.94±0.41		2.06±0.78
t或χ²		1.799		1.622		1.369		0.398		0.848		0.785		0.912		5.739^＊＊

组别	n		年龄（岁）		孕前BMI （kg/m²）	糖尿病家族史	产次（次）		孕期使用胰岛素		新生儿体质量（g）		FBG （mmol/L）		OGTT 1 h血糖（mmol/L）
糖代谢正常组	192		29.24±5.23		23.02±3.16	71（36.98）	1.62±0.35		16（8.33）		3 215.48±504.19		5.08±0.43		9.91±1.26
糖代谢异常组	46		30.12±4.87		24.78±2.28	20（43.48）	1.71±0.26		8（17.39）		3 301.52±315.73		5.16±0.38		10.32±1.12
t或χ²			1.038		3.559^＊＊	0.664	1.638		2.433		1.016		1.158		2.023^＊
组别		OGTT 2 h血糖（mmol/L）		FINS （mIU/L）		收缩压（mmHg）		舒张压（mmHg）		总胆固醇（mmol/L）		LDL-C （mmol/L）		三酰甘油（mmol/L）		SFRP5 （μg/L）
糖代谢正常组		8.73±0.85		14.36±2.59		124.52±13.75		80.69±9.21		5.01±0.84		3.02±0.98		1.87±0.48		2.99±1.03
糖代谢异常组		8.97±0.63		15.03±2.18		127.48±10.36		81.27±7.33		5.12±0.53		3.14±0.69		1.94±0.41		2.06±0.78
t或χ²		1.799		1.622		1.369		0.398		0.848		0.785		0.912		5.739^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
孕前BMI	0.612	0.264	5.374	0.020	1.844	1.099~3.094
OGTT 1 h血糖	0.523	0.301	3.019	0.082	1.687	0.935~3.043
SFRP5	-0.231	0.106	4.749	0.029	0.794	0.645~0.977
常数项	0.281	0.118	5.671	0.017	1.324	-

变量	β	SE	Wald χ²	P	OR	OR 95%CI
孕前BMI	0.612	0.264	5.374	0.020	1.844	1.099~3.094
OGTT 1 h血糖	0.523	0.301	3.019	0.082	1.687	0.935~3.043
SFRP5	-0.231	0.106	4.749	0.029	0.794	0.645~0.977
常数项	0.281	0.118	5.671	0.017	1.324	-

分泌型卷曲相关蛋白5与妊娠期糖尿病患者产后糖代谢异常的关系研究

The relationship between secreted frizzled-related protein 5 and abnormal postpartum glucose metabolism in patients with gestational diabetes mellitus

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