早期识别妊娠期糖尿病(GDM)旨在降低不良孕产妇和围产期结局的风险。目前,目前尚无公认的生物标志物在临床上对GDM的准确预测有用.在这项研究中,我们检测了孕早期血清腐胺水平是否有变化,是否能改善GDM的预测。
本研究是在北京妇产医院进行的巢式病例对照研究。我们检查了47名GDM女性和47名年龄和体重指数(BMI)匹配的正常血糖女性在怀孕8-12周时的血清腐胺。人体测量,在同一时期获得了临床和实验室变量.使用受试者工作特征曲线(ROC)和曲线下面积(AUC)评估预测模型的区分和校准。
妊娠早期的血清腐胺在后来发展为GDM的女性中明显较高。当单独使用腐胺来预测GDM的风险时,列线图的AUC为0.904(灵敏度为100%,特异性为83%,95%CI=0.832-0.976,P<0.001)。当结合传统的危险因素(孕前BMI和空腹血糖),AUC为0.951(敏感性为89.4%,特异性为91.5%,95%CI=0.906-0.995,P<0.001)。
这项研究表明,GDM妇女在孕早期的血清腐胺水平升高。循环腐胺可作为GDM的有价值的预测生物标志物。
Early identification of gestational diabetes mellitus (GDM) aims to reduce the risk of adverse maternal and perinatal outcomes. Currently, no acknowledged biomarker has proven clinically useful for the accurate prediction of GDM. In this study, we tested whether serum
putrescine level changed in the first trimester and could improve the prediction of GDM.
This study is a nested
case-control study conducted in Beijing Obstetrics and Gynecology Hospital. We examined serum putrescine at 8-12 weeks pregnancy in 47 women with GDM and 47 age- and body mass index (BMI)-matched normoglycaemic women. Anthropometric, clinical and laboratory variables were obtained during the same period. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to assess the discrimination and calibration of the prediction models.
Serum
putrescine in the first trimester was significantly higher in women who later developed GDM. When using
putrescine alone to predict the risk of GDM, the AUC of the nomogram was 0.904 (sensitivity of 100% and specificity of 83%, 95% CI=0.832-0.976, P<0.001). When combined with traditional risk factors (prepregnant BMI and fasting blood glucose), the AUC was 0.951 (sensitivity of 89.4% and specificity of 91.5%, 95% CI=0.906-0.995, P<0.001).
This study revealed that GDM women had an elevated level of serum putrescine in the first trimester. Circulating
putrescine may serve as a valuable predictive biomarker for GDM.