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

doi:10.11958/20220140

Abstract

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

CLC Number:

R714.256

Figures/Tables 3

References 19

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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	-