血清VCAM-1及GLP-1水平与妊娠期糖尿病孕妇不良妊娠结局的相关性分析

目的探讨血管细胞黏附分子(vascular cell adhesion molecule-1,VCAM-1)及胰高血糖素样肽-1(glucagon like peptide-1,GLP-1)水平与妊娠期糖尿病孕妇不良妊娠结局的相关性。方法选择2016年1月至2019年1月在邢台市第三医院诊治的妊娠期糖尿病患者140例为观察组,同期产检正常孕妇140例为对照组。两组在入组后第2 d清晨空腹采集肘部静脉血,比较两组VCAM-1、GLP-1水平、妊娠结局及其相关性。结果观察组血清VCAM-1水平显著高于对照组,GLP-1水平显著低于对照组,差异有统计学意义(P<0.05);观察组的巨大儿、新生儿低血糖、剖宫产率显著高于对照组(P<0.05);对观察组进行多因素Logistic回归分析显示,VCAM-1水平升高(OR=3.106,P=0.017,95%CI:2.542-4.549),GLP-1水平降低(OR=2.674,P=0.024,95%CI:1.159-3.631)是不良母婴结局的危险因素。结论妊娠期糖尿病患者中血清VCAM-1、GLP-1水平发生较大变化,是不良妊娠结局的危险因素,在临床上可加强妊娠期糖尿病相关指标的监测,制定合理的治疗措施干预妊娠的结局。

Analysis of the correlation between serum VCAM-1 and GLP-1 levels and adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus

Objective To investigate the correlation between serum VCAM-1 and GLP-1 levels and adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus. Methods 140 cases of gestational diabetes mellitus diagnosed and treated in The Third Hospital of Xingtai City from January 2016 to January 2019 were selected as the observation group,140 normal pregnant women without gestational diabetes during the same time were selected as the control group. The venous blood of elbow of women in two groups was collected on the second day after admission. The VCAM-1 and GLP-1 levels,pregnancy outcome and their correlation between the two groups were compared. Results The serum VCAM-1 level of the observation group was significantly higher than that of the control group,and the GLP-1 level was significantly lower than that of the control group( P < 0. 05). The rates of macrosomia,neonatal hypoglycemia and cesarean section in the observation group were significantly higher than those in the control group( P <0. 05). Multivariate logistic regression analysis showed that VCAM-1 increased( OR = 3. 106,P = 0. 017,95% CI: 2. 542-4. 549),and GLP-1 decreased( OR = 2. 674,P = 0. 024,95 % CI: 1. 159-3. 631) were risk factors for adverse maternal and neonatal outcomes in the middle and late pregnancy in the observation group. Conclusion The serum levels of VCAM-1 and GLP-1 in patients with gestational diabetes mellitus change greatly,which are risk factors for adverse pregnancy outcomes. The monitoring of gestational diabetes-related indicators should be strengthened clinically,and reasonable treatment interventions for the outcome of pregnancy canbe formulated.