Relationship between serum Spexin, FoxO1 and insulin resistance as well as prognosis in patients with gestational diabetes mellitus

doi:10.11958/20250653

Abstract

Abstract:

Objective To investigate the correlation of serum levels of Spexin, FoxO1 and insulin resistance (IR) with prognosis in patients with gestational diabetes mellitus (GDM). Methods A total of 198 patients with GDM were prospectively selected as the GDM group, and 195 healthy pregnant women who underwent physical examinations during the same period were selected as the control group. The age at enrollment, gestational age, triglyceride (TG), pre-pregnancy body weight, fasting insulin (FINS), parity, fasting blood glucose (FBG), total cholesterol (TC) and homeostasis model assessment of insulin resistance index (HOMA-IR) of the subjects were collected. The serum levels of Spexin and FoxO1 in subjects were detected by enzyme-linked immunosorbent assay (ELISA). According to the pregnancy outcome, the GDM patients were divided into the adverse pregnancy outcome group (96 cases) and the good pregnancy outcome group (102 cases). The correlations between serum Spexin, FoxO1, and HOMA-IR in GDM patients were analyzed by Pearson's method. Logistic regression was used to analyze risk factors affecting the pregnancy outcome of GDM patients. The predictive value of serum Spexin and FoxO1 levels for the pregnancy outcome of GDM patients was analyzed by receiver operating characteristic (ROC) curve. Results The serum levels of FINS, TG, FBG, Spexin, FoxO1 and HOMA-IR were higher in the GDM group than those in the control group (P<0.01). Pearson correlation analysis showed that serum levels of Spexin and FoxO1 in GDM patients were positively correlated with HOMA-IR, and serum level of Spexin was positively correlated with FoxO1 (P<0.05). The incidences of gestational hypertension, cesarean section, macrosomia, neonatal malformations, low birth weight infants and neonatal asphyxia were higher in the GDM group than those in the control group (P<0.05). Serum levels of Spexin and FoxO1 and FINS, FBG and HOMA-IR were significantly higher in the adverse pregnancy group than those in the good pregnancy group (P<0.01). Multivariate Logistic regression analysis showed that the increased Spexin and FoxO1 were the risk factor for adverse pregnancy outcomes in GDM patients (P<0.01). The ROC curve analysis showed that the area under the curve (AUC) of serum Spexin and FoxO1 levels for predicting pregnancy outcomes in GDM patients was 0.887 and 0.883, respectively, and the AUC of combined prediction was 0.942. Conclusion Serum levels of Spexin and FoxO1 are elevated in GDM patients, and both are related to IR. The combination of the two can assist in judging the pregnancy outcome of GDM patients.

Key words: diabetes, gestational, insulin resistance, forkhead box protein O1, pregnancy outcome, Spexin

CLC Number:

R587.2

Figures/Tables 6

References 16

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组别	n		产次/次		孕前体质量/kg			TC/（mmol/L）
对照组	195		1.70±0.65		54.32±6.84			4.73±1.58
GDM组	198		1.79±0.70		53.96±6.28			4.92±1.64
t			1.261		0.544			1.113
组别	TG/（mmol/L）			FBG/（mmol/L）			FINS/（mIU/L）
对照组	2.38±0.81			4.71±1.58			6.82±2.26
GDM组	3.17±1.05			6.13±2.03			13.67±4.55
t	8.358^＊＊			7.329^＊＊			17.211^＊＊
组别		Spexin/（μg/L）				FoxO1/（μg/L）			HOMA-IR
对照组		3.42±1.05				1.02±0.32			1.50±0.49
GDM组		6.73±2.17				1.67±0.51			2.83±0.83
t		14.205^＊＊				13.792^＊＊			14.062^＊＊

组别	n		产次/次		孕前体质量/kg			TC/（mmol/L）
对照组	195		1.70±0.65		54.32±6.84			4.73±1.58
GDM组	198		1.79±0.70		53.96±6.28			4.92±1.64
t			1.261		0.544			1.113
组别	TG/（mmol/L）			FBG/（mmol/L）			FINS/（mIU/L）
对照组	2.38±0.81			4.71±1.58			6.82±2.26
GDM组	3.17±1.05			6.13±2.03			13.67±4.55
t	8.358^＊＊			7.329^＊＊			17.211^＊＊
组别		Spexin/（μg/L）				FoxO1/（μg/L）			HOMA-IR
对照组		3.42±1.05				1.02±0.32			1.50±0.49
GDM组		6.73±2.17				1.67±0.51			2.83±0.83
t		14.205^＊＊				13.792^＊＊			14.062^＊＊

组别	n		妊娠期高血压		胎膜早破		剖宫产		巨大儿
对照组	195		17（8.72）		23（11.79）		29（14.87）		7（3.59）
GDM组	198		50（25.25）		29（14.65）		59（29.80）		22（11.11）
χ²			18.993^＊＊		0.696		12.595^＊＊		8.132^＊＊
组别		新生儿畸形		早产		低体质量儿		新生儿窒息
对照组		5（2.56）		11（5.64）		6（3.08）		4（2.05）
GDM组		16（8.08）		16（8.08）		17（8.59）		17（8.59）
χ²		5.911^＊		0.914		5.411^＊		8.294^＊＊

组别	n		妊娠期高血压		胎膜早破		剖宫产		巨大儿
对照组	195		17（8.72）		23（11.79）		29（14.87）		7（3.59）
GDM组	198		50（25.25）		29（14.65）		59（29.80）		22（11.11）
χ²			18.993^＊＊		0.696		12.595^＊＊		8.132^＊＊
组别		新生儿畸形		早产		低体质量儿		新生儿窒息
对照组		5（2.56）		11（5.64）		6（3.08）		4（2.05）
GDM组		16（8.08）		16（8.08）		17（8.59）		17（8.59）
χ²		5.911^＊		0.914		5.411^＊		8.294^＊＊

组别			n	年龄/岁		孕前体质量/kg		产次/次
良好妊娠组			102	28.68±5.69		54.12±6.37		1.73±0.66
不良妊娠组			96	29.44±5.83		53.79±6.18		1.85±0.71
t				0.930		0.370		1.319
组别	孕周/周			FINS/（mIU/L）		TG/（mmol/L）	TC/（mmol/L）
良好妊娠组	26.01±1.60			11.56±3.85		3.06±1.02	4.78±1.60
不良妊娠组	25.82±1.55			15.91±5.29		3.29±1.10	5.07±1.68
t	0.834			6.628^＊＊		1.592	1.244
组别		FBG/ （mmol/L）			HOMA-IR		Spexin/（μg/L）		FoxO1/（μg/L）
良好妊娠组		5.42±1.81			2.12±0.71		4.68±1.54		1.41±0.39
不良妊娠组		6.88±2.29			3.58±1.19		8.91±2.82		1.95±0.63
t		5.014^＊＊			10.567^＊＊		13.178^＊＊		7.444^＊＊