妊娠期糖尿病合并妊娠期亚临床甲状腺功能减退患者IL-1、hs-CRP、25-OH-D水平变化及临床价值

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摘要目的探究IL-1、hs-CRP、25-OH-D在妊娠期糖尿病(GDM)合并妊娠期亚临床甲状腺功能减退症(SCH)中的早期诊断价值。方法回顾性分析2017年8月至2018年8月本院收治的122例GDM孕妇的临床资料,GDM合并SCH作为GDM合并SCH组(n=61),单纯GDM则作为GDM组(n=61),另外选择同期健康孕妇作为健康妊娠组(n=61);对比分析三组孕妇IL-1、hs-CRP、25-OH-D、甲状腺过氧化物酶抗体(TPOAb)、胰岛素抵抗指数(IRI)水平变化,并行Pearson相关分析。结果三组孕妇IL-1、hs-CRP、25-OH-D水平有显著差异(P<0.05);两组组间比较IL-1、hs-CRP水平,GDM合并SCH组、GDM组均显著高于健康妊娠组(P<0.05),而GDM合并SCH组显著高于GDM组(P<0.05);25-OH-D水平,GDM合并SCH组、GDM组均显著低于健康妊娠组(P<0.05),而GDM合并SCH组显著低于GDM组(P<0.05)。三组孕妇TPOAb、IRI差异显著(P<0.05),且GDM合并SCH组、GDM组显著高于健康妊娠组(P<0.05),而GDM合并SCH组显著高于GDM组(P<0.05)。相关性分析发现,TPOAb、IRI与IL-1、hs-CRP呈正相关(P<0.05),IRI与25-OH-D呈负相关(P<0.05)。ROC曲线分析结果显示,IL-1、hs-CRP、25-OH-D、三者联合诊断AUC分别为0.884、0.860、0.724、0.905。结论血清IL-1、hs-CRP、25-OH-D与GDM合并SCH有密切关系,临床可结合三者水平对GDM合并SCH进行预测,并作为临床干预的主要依据。

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	王芳
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关键词 ：妊娠期糖尿病(GDM), 妊娠期亚临床甲状腺功能减退症(SCH), 炎性因子, 维生素D

Abstract：Objective To explore the early diagnostic value of IL-1,hs-CRP,25-OH-D in gestational diabetes mellitus patients complicated with gestational subclinical hypothyroidism. Methods Clinical data of 122 GDM patients who were treated in the study hospital from August 2017 to August 2018 were retrospectively analyzed. GDM with SCH group included 61 patients, and pure GDM group included 61 patients. Another 61 healthy pregnant women who were treated in the study hospital during the same period were selected as control group. The differences in the levels of IL-1, hs-CRP, 25-OH-D, thyroid peroxidase antibody (TPOAb) and insulin resistance index (IRI) among the three groups were examined, and the Pearson correlation coefficients between these indicators were calculated. Results There were significant differences in the levels of IL-1, hs-CRP, and 25-OH-D among the three groups (P<0.05); the levels of IL-1, hs-CRP in the GDM with SCH group and the GDM group were significantly higher than those of the healthy control group (P<0.05), and the levels of these three indicators were significantly higher in the GDM with SCH group than the GDM group (P<0.05). The levels of 25-DH-D in the GDM with SCH group and the GDM group were significantly lower than that in the healthy control group (P<0.05), and the level of 25-DH-D in the GDM with SCH group was significantly lower than that in the GDM group (P<0.05). There were significant differences in the levels of TPOAb and IRI among the three groups (P<0.05); the levels of TPOAb and IRI in the SCH with GDM group and the GDM group were significantly higher than the healthy control group (P<0.05), and the levels of these two indicators were significantly higher in the SCH with GDM group than the GDM group (P<0.05). In the correlation analysis, the levels of TPOAb and IRI were positively correlated with IL-1 and hs-CRP (P<0.05), while IRI was negatively correlated with 25-OH-D (P<0.05). The ROC curve analysis showed that AUC of IL-1, hs-CRP, 25-OH-D and the combination of these three indicators were 0.884, 0.860, 0.724 and 0.905, respectively. Conclusion The serum IL-1, hs-CRP, 25-OH-D is associated with GDM with SCH, and the levels of these indicators may be used to predict the occurrence of GDM with SCH. These findings may be used as the basis for clinical intervention.

Key words： GDM SCH inflammatory factors Vitamin D

收稿日期: 2020-06-24

ZTFLH:

R71

基金资助:海军总医院创新培育基金(HLCX-2017-12)

通讯作者: 邢梅(1060191533@qq.com)

引用本文:

王芳, 王秀梅, 郭亚利, 邢梅. 妊娠期糖尿病合并妊娠期亚临床甲状腺功能减退患者IL-1、hs-CRP、25-OH-D水平变化及临床价值[J]. 中国生育健康杂志, 2022, 33(2): 141-144. WANG Fang, WANG Xiumei, GUO Yali, XING Mei. Changes and clinical value of IL-1, hs-CRP and 25-OH-D levels in patients with gestational diabetes mellitus and gestational subclinical hypothyroidism. Chinese Journal of Reproductive Health, 2022, 33(2): 141-144.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2022/V33/I2/141

1 Drover S,Villanger GD,Aase H,et al.Maternal Thyroid Function During Pregnancy or Neonatal Thyroid Function and Attention Deficit Hyperactivity Disorder:A Systematic Review.Epidemiology,2019,30:130-144.
2 高劲松,边旭明.妊娠期亚临床甲状腺功能减退症的诊断标准及危害和处理.实用妇产科杂志,2015,31:888-890.
3 Yang S,Shi F T,Leung P C,et al.Low Thyroid Hormone in Early Pregnancy Is Associated with an Increased Risk of Gestational Diabetes Mellitus J Clin EndocrinolMetab,2016,101:jc20161506.
4 黄三秀.妊娠期糖尿病合并亚临床甲减对妊娠结局的影响研究.实用临床医药杂志,2016,20:73-75.
5 Abell SK,De Courten B,Boyle JA,et al.Inflammatory and Other Biomarkers:Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus.Int J Mol Sci, 2015,16:13442-13473.
6 Corcoy R,Mendoza LC,Simmons D,et al.Re:Vitamin D and gestational diabetes mellitus:a systematic review based on data free of Hawthorne effect.Clin Chim Acta,2018,125:1338-1339.
7 中华医学会内分泌学分会.妊娠和产后甲状腺疾病诊治指南.中华内分泌代谢杂志,2012,28:354-367.
8 中华医学会妇产科学分会产科学组.妊娠合并糖尿病诊治指南(2014).健康管理,2014,8:489-498.
9 蒋萌,林建华.妊娠期血液系统生理变化.实用妇产科杂志,2016,32:641-643.
10 Soma-Pillay P,Nelson-Piercy C,Tolppanen H,et al.Physiological changes in pregnancy.Cardiovasc J Afr,2016,27:89-94.
11 叶华莹.妊娠期糖尿病产后发展为2型糖尿病的相关因素研究进展.国际妇产科学杂志,2018,45:28-32.
12 王巧敏,刘怀昌,李蕊,等.甲状腺功能减退对妊娠期糖尿病孕妇糖代谢及胰岛素敏感性的影响.广东医学,2016,37:245-246.
13 叶可君,彭梦佳,戴洁,等.妊娠期糖尿病与妊娠期高血压疾病患者甲状腺功能变化情况与临床干预研究.中国妇幼保健,2018,33:27-31.
14 周秋明,盛望望,李颖,等.天津市某社区卫生服务中心建卡孕妇妊娠糖尿病危险因素分析.中国医学前沿杂志(电子版),2019,11:90-94.
15 李艳,周淑.妊娠合并亚临床甲状腺功能减退症相关危险因素分析.中国计划生育和妇产科,2017,9:52-56.
16 Katra P,Dereke J,Nilsson C,et al.Plasma Levels of the Interleukin-1-Receptor Antagonist Are Lower in Women with Gestational Diabetes Mellitus and Are Particularly Associated with Postpartum Development of Type 2 Diabetes.PLoS One,2016,11:e0155701.
17 何方,戴海龙,光雪峰.亚临床甲状腺功能减退与心血管疾病的研究进展.中国心血管病研究,2016,14:1-5.
18 孙莹,梁晓春.维生素D缺乏在胰岛素抵抗中的作用及其中药研究价值.世界中西医结合杂志,2017,12:144-147.
19 刘鑫颖,彭伟,王丽霞,等.妊娠早期妇女维生素D营养状态及其与甲状腺功能减退症关系.青岛大学医学院学报,2017,53:56-59.
20 李珍梅,钟义春,陈晓正,等.亚临床甲状腺功能减退合并妊娠期糖尿病孕妇血清维生素D水平的研究.现代诊断与治疗,2016,27:2657-2658.