Clinical value of serum HbA1c, Alarin and Ficolin-3 levels in predicting pregnancy outcome in patients with gestational diabetes mellitus

doi:10.11958/20231789

Abstract

Abstract:

Objective To explore the value of the combination of serum hemoglobin A1c (HbA1c), Alarin and Ficolin-3 in predicting adverse pregnancy outcomes in patients with gestational diabetes mellitus (GDM). Methods From March 2021 to March 2023, 129 GDM patients who underwent prenatal examination and hospital delivery in Yantai Yeda Hospital were collected as the GDM group, while 133 pregnant women with normal glucose tolerance test results were regarded as the control group. Fully automated glycated hemoglobin analyzer was applied to detect serum HbA1c level. Enzyme linked immunosorbent assay (ELISA) was applied to detect serum Alarin and Ficolin-3 levels. Pearson method was used to analyze the correlation between serum HbA1c, Alarin, Ficolin-3 levels and 2 hour postprandial glucose (2 h PG), fasting blood glucose (FBG) and homeostasis model assessment method for insulin resistance (HOMA-IR) in GDM patients. Logistic regression was applied to analyze the relationship between HbA1c, Alarin, Ficolin-3 levels and adverse pregnancy outcomes in GDM patients. Receiver operating characteristic (ROC) curve was plotted to analyze the value of serum HbA1c, Alarin and Ficolin-3 levels in predicting adverse pregnancy outcomes in GDM patients. Results The 2 h PG, FBG, HOMA-IR, and serum HbA1c, Alarin, and Ficolin-3 levels were significantly higher in the GDM group than those in the control group (P<0.05). The serum levels of HbA1c, Alarin and Ficolin-3 were positively correlated with 2 h PG, FBG and HOMA-IR in GDM patients (P<0.05). The serum HbA1c, Alarin and Ficolin-3 levels were greatly higher in GDM patients with poor blood glucose control than those in GDM patients with good blood glucose control (P<0.05). The above levels of three indicators in GDM patients with adverse pregnancy outcomes were significantly higher than those in GDM patients without adverse pregnancy outcomes (P<0.05). Elevated levels of HbA1c, Alarin and Ficolin-3 were independent risk factors for adverse pregnancy outcomes in GDM patients (P<0.05). The area under the curves of HbA1c, Alarin and Ficolin-3 alone and in combination were 0.840, 0.865, 0.815 and 0.979, respectively in predicting adverse pregnancy outcomes in GDM patients. Conclusion The serum HbA1c, Alarin and Ficolin-3 levels are abnormally elevated in GDM patients, and the combined detection of the three can improve the value in predicting adverse pregnancy outcomes.

Key words: diabetes, gestational, glycated hemoglobin A, pregnancy outcome, Alarin, Ficolin-3

CLC Number:

R714.256

Figures/Tables 7

References 22

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组别		n	年龄/岁		孕前BMI/（kg/m²）		SBP/（mmHg）		DBP/（mmHg）		初产妇		孕期/周		孕次/次		2 h PG/（mmol/L）
对照组		133	27.90±4.09		22.94±2.87		119.82±10.27		70.32±6.85		92（69.2）		27.04±1.28		1.98±0.40		6.43±1.57
GDM组		129	28.52±4.02		23.03±3.10		120.45±11.06		70.94±6.30		89（69.0）		27.10±1.45		2.01±0.36		10.48±1.76
t或χ²			1.231		0.244		0.478		0.765		0.001		0.374		0.642		19.666^＊＊
组别	FBG/（mmol/L）			HOMA-IR		HDL-C/（mmol/L）		LDL-C/（mmol/L）		TG/（mmol/L）		TC/（mmol/L）		HbA1c/%		Alarin/（mg/L）		Ficolin-3/（μg/L）
对照组	4.12±0.69			1.72±0.55		1.36±0.30		2.50±0.69		2.36±0.80		4.95±0.94		3.77±0.72		0.21±0.06		20.55±6.05
GDM组	6.51±0.83			3.60±0.71		1.38±0.35		2.53±0.79		2.41±0.76		5.13±1.16		6.00±1.14		0.42±0.14		32.28±10.42
t或χ²	25.364^＊＊			24.249^＊＊		0.501		0.329		0.515		1.388		18.838^＊＊		16.350^＊＊		11.103^＊＊

组别		n	年龄/岁		孕前BMI/（kg/m²）		SBP/（mmHg）		DBP/（mmHg）		初产妇		孕期/周		孕次/次		2 h PG/（mmol/L）
对照组		133	27.90±4.09		22.94±2.87		119.82±10.27		70.32±6.85		92（69.2）		27.04±1.28		1.98±0.40		6.43±1.57
GDM组		129	28.52±4.02		23.03±3.10		120.45±11.06		70.94±6.30		89（69.0）		27.10±1.45		2.01±0.36		10.48±1.76
t或χ²			1.231		0.244		0.478		0.765		0.001		0.374		0.642		19.666^＊＊
组别	FBG/（mmol/L）			HOMA-IR		HDL-C/（mmol/L）		LDL-C/（mmol/L）		TG/（mmol/L）		TC/（mmol/L）		HbA1c/%		Alarin/（mg/L）		Ficolin-3/（μg/L）
对照组	4.12±0.69			1.72±0.55		1.36±0.30		2.50±0.69		2.36±0.80		4.95±0.94		3.77±0.72		0.21±0.06		20.55±6.05
GDM组	6.51±0.83			3.60±0.71		1.38±0.35		2.53±0.79		2.41±0.76		5.13±1.16		6.00±1.14		0.42±0.14		32.28±10.42
t或χ²	25.364^＊＊			24.249^＊＊		0.501		0.329		0.515		1.388		18.838^＊＊		16.350^＊＊		11.103^＊＊

指标	HbA1c	Alarin	Ficolin-3
2 h PG	0.490^＊＊	0.491^＊＊	0.524^＊＊
FBG	0.516^＊＊	0.503^＊＊	0.519^＊＊
HOMA-IR	0.525^＊＊	0.496^＊＊	0.529^＊＊

指标	HbA1c	Alarin	Ficolin-3
2 h PG	0.490^＊＊	0.491^＊＊	0.524^＊＊
FBG	0.516^＊＊	0.503^＊＊	0.519^＊＊
HOMA-IR	0.525^＊＊	0.496^＊＊	0.529^＊＊

血糖控制情况	n	HbA1c/%	Alarin/（mg/L）	Ficolin-3/（μg/L）
血糖控制好	71	5.39±0.68	0.35±0.09	28.06±8.24
血糖控制差	58	6.74±1.15	0.50±0.14	37.44±10.53
t		7.899^＊＊	7.238^＊＊	5.535^＊＊