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

doi:10.11958/20252188

Abstract

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

CLC Number:

R714.2

Figures/Tables 4

References 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