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

doi:10.11958/20252188

天津医药 ›› 2025, Vol. 53 ›› Issue (10): 1057-1061.doi: 10.11958/20252188

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

吴欢(), 庄英^△(), 周敏, 彭子萍, 于婵

上海市第一妇婴保健院/同济大学附属妇产科医院妇产科（邮编 200040）

收稿日期:2025-05-30 修回日期:2025-07-21 出版日期:2025-10-15 发布日期:2025-10-12
通讯作者: ^△E-mail：zhuangying@51mch.com
作者简介:吴欢（1992），女，主管护师，主要从事妊娠糖尿病方面研究。E-mail：wuhuaaa92@126.com

Analysis of the predictive value of serum peroxiredoxin 4 in early pregnancy for the risk of gestational diabetes

WU Huan(), ZHUANG Ying^△(), ZHOU Min, PENG Ziping, YU Chan

Department of Obstetrics and Gynecology, Shanghai First Maternal and Child Health Care Hospital / Obstetrics and Gynecology Hospital of Tongji University, Shanghai 200040, China

Received:2025-05-30 Revised:2025-07-21 Published:2025-10-15 Online:2025-10-12
Contact: ^△E-mail：zhuangying@51mch.com

吴欢, 庄英, 周敏, 彭子萍, 于婵. 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[J]. 天津医药, 2025, 53(10): 1057-1061.

WU Huan, ZHUANG Ying, ZHOU Min, PENG Ziping, YU Chan. Analysis of the predictive value of serum peroxiredoxin 4 in early pregnancy for the risk of gestational diabetes[J]. Tianjin Medical Journal, 2025, 53(10): 1057-1061.

摘要/Abstract

摘要：

目的探讨妊娠糖尿病（GDM）患者早期血清过氧化物还原酶4水平变化以及对GDM的诊断价值。方法纳入妊娠期女性372例为研究对象，根据口服葡萄糖耐量试验（OGTT）结果明确是否诊断为GDM，将妊娠女性分为GDM组（89例）与对照组（283例）。对比2组患者的临床资料、实验室指标、过氧化物还原酶4水平，分析血清过氧化物还原酶4水平与实验室指标的相关性、GDM发生的危险因素和对GDM的诊断效能。结果 GDM组糖尿病家族史占比，胰岛素抵抗指数（HOMA-IR）、空腹血糖（FPG）、餐后1 h血糖（1 hPG）、餐后2 h血糖（2 hPG）、C肽及血清过氧化物还原酶4高于对照组，胰岛β细胞功能指数（HOMA-β）低于对照组（均P<0.05）。GDM组患者血清过氧化物还原酶4水平与HOMA-IR、FPG、1 hPG、2 hPG、C肽呈正相关，与HOMA-β呈负相关（均P<0.05）；多因素Logistic回归分析结果显示，HOMA-IR、FPG、1 hPG、2 hPG、C肽和过氧化物还原酶4升高是发生GDM的危险因素，HOMA-β升高是发生GDM的保护因素（P<0.05）；过氧化物还原酶4诊断GDM的曲线下面积（AUC）为0.912（95%CI：0.871~0.953），当最佳截断值为0.93 U/L时，敏感度为79.79%，特异度为89.36%。结论 GDM患者血清中过氧化物还原酶4水平明显升高，对GDM具有良好的诊断效能。

关键词: 糖尿病, 妊娠, 过氧化物还原酶, 胰岛素抵抗, Logistic模型, ROC曲线

Abstract:

Objective To investigate changes of serum peroxiredoxin 4 level in patients with gestational diabetes mellitus (GDM) at the early stage and its diagnostic value for GDM. Methods A total of 372 early pregnant women who visited our hospital from March 2021 to May 2024 were selected as the study subjects. The diagnosis of GDM was determined based on the results 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, laboratory indicators and levels of peroxiredoxin 4 were compared between two groups of patients. The correlation between serum peroxiredoxin 4 levels and laboratory indicators was analyzed. Risk factors for the occurrence of GDM and its diagnostic efficacy for GDM were also analyzed. Results The proportion of family history of diabetes, insulin resistance index (HOMA-IR), fasting plasma glucose (FPG), postprandial 1 h glucose (1 hPG), postprandial 2 h glucose (2 hPG), C-peptide and 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 positively correlated with HOMA-IR, FPG, 1 hPG, 2 hPG and C-peptide in the GDM group, and which was negatively correlated with HOMA-β (P<0.05). Multifactorial Logistic regression analysis showed that elevated HOMA-IR, FPG, 1 hPG, 2 hPG, C-peptide and peroxidase reductase 4 were risk factors for the occurrence of GDM, while elevated HOMA-β was the protective factor for the occurrence of GDM (P<0.05). The area under the curve (AUC) for peroxidase reductase 4 in diagnosing GDM was 0.912 (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. Conclusion The serum level of peroxiredoxin 4 in GDM patients is significantly elevated, showing good diagnostic efficacy for GDM.

Key words: diabetes, gestational, peroxiredoxin Ⅲ, insulin resistance, Logistic models, ROC curve

中图分类号:

R714.2

图/表 4

参考文献 19

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组别	n		年龄/岁		孕前BMI/（kg/m²）		身高/m
对照组	283		31.91±5.24		23.06±3.27		1.61±0.07
GDM组	89		32.46±5.07		23.52±3.95		1.60±0.05
t			0.870		1.099		1.251
组别		孕周/周		孕次/次		糖尿病家族史
对照组		26.15±3.97		1.55±0.52		21（7.42）
GDM组		26.41±4.03		1.58±0.49		13（14.61）
t或χ²		0.537		0.481		4.210^＊

组别	n		年龄/岁		孕前BMI/（kg/m²）		身高/m
对照组	283		31.91±5.24		23.06±3.27		1.61±0.07
GDM组	89		32.46±5.07		23.52±3.95		1.60±0.05
t			0.870		1.099		1.251
组别		孕周/周		孕次/次		糖尿病家族史
对照组		26.15±3.97		1.55±0.52		21（7.42）
GDM组		26.41±4.03		1.58±0.49		13（14.61）
t或χ²		0.537		0.481		4.210^＊

组别		n		TG/（mmol/L）			TC/（mmol/L）			LDL-C/（mmol/L）
对照组		283		2.54±0.93			5.84±0.97			2.52±0.33
GDM组		89		2.71±1.01			5.93±1.02			2.48±0.31
t				1.473			0.754			1.102
组别	HDL-C/（mmol/L）					HOMA-IR			HOMA-β		FINS/ （mIU/L）
对照组	1.38±0.33					1.95±0.53			60.78±11.59		11.62±4.78
GDM组	1.42±0.31					4.57±0.67			33.82±9.43		12.03±4.92
t	0.759					38.060^＊＊			46.180^＊＊		0.701
组别			FPG/ （mmol/L）		1 hPG/（mmol/L）			2 hPG/（mmol/L）				C肽/ （μg/L）
对照组			4.39±0.26		7.29±1.31			5.87±0.96				0.51±0.09
GDM组			5.47±0.33		10.35±1.82			8.29±1.51				0.64±0.11
t			31.940^＊＊		17.393^＊＊			17.848^＊＊				11.244^＊＊

组别		n		TG/（mmol/L）			TC/（mmol/L）			LDL-C/（mmol/L）
对照组		283		2.54±0.93			5.84±0.97			2.52±0.33
GDM组		89		2.71±1.01			5.93±1.02			2.48±0.31
t				1.473			0.754			1.102
组别	HDL-C/（mmol/L）					HOMA-IR			HOMA-β		FINS/ （mIU/L）
对照组	1.38±0.33					1.95±0.53			60.78±11.59		11.62±4.78
GDM组	1.42±0.31					4.57±0.67			33.82±9.43		12.03±4.92
t	0.759					38.060^＊＊			46.180^＊＊		0.701
组别			FPG/ （mmol/L）		1 hPG/（mmol/L）			2 hPG/（mmol/L）				C肽/ （μg/L）
对照组			4.39±0.26		7.29±1.31			5.87±0.96				0.51±0.09
GDM组			5.47±0.33		10.35±1.82			8.29±1.51				0.64±0.11
t			31.940^＊＊		17.393^＊＊			17.848^＊＊				11.244^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
HOMA-IR	0.578	0.279	5.212	0.039	1.329	1.095~3.427
HOMA-β	-0.209	0.082	5.689	0.011	0.892	0.782~0.995
FPG	0.325	0.107	6.177	0.002	1.803	1.326~4.241
1 hPG	0.496	0.183	5.850	0.007	1.539	1.103~3.582
2 hPG	0.424	0.214	5.121	0.048	1.245	1.037~3.304
C肽	0.291	0.096	6.171	0.003	1.748	1.271~4.162
过氧化物还原酶4	0.503	0.183	5.889	0.006	1.692	1.243~4.087
常数项	-2.467	0.542	9.457	<0.001	0.085

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

Analysis of the predictive value of serum peroxiredoxin 4 in early pregnancy for the risk of gestational diabetes

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