妊娠期糖尿病患者血清miR-450a-5p和CREB表达水平及临床意义

目的 检测微小核糖核酸（mircro RNAs, miR）-450a-5p和环磷酸腺苷反应元件结合蛋白(c-AMP response element binding protein,CREB)在妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血清中的表达情况，探讨其对GDM诊断的临床意义。方法 选取2018年4月～2020年4月在如皋市人民医院妇产科建档产检的120例GDM孕妇为GDM组，选择同期120例健康孕妇为对照组。采用实时荧光定量PCR(qRT-PCR)法检测受试者血清中miR-450a-5p水平；采用酶联免疫吸附实验（ELISA）检测受试者血清中CREB表达水平；Pearson法分析血清miR-450a-5p和CREB水平与GDM孕妇临床病理特征相关性；受试者工作特征（ROC）曲线分析血清中miR-450a-5p和CREB表达水平对GDM的诊断价值以及采用Logistic回归分析GDM发生的影响因素。结果 与对照组相比，GDM组患者血清中miR-450a-5p表达水平（0.69±0.15 vs 1.58±0.34）显著下调（t=26.23...

Expression Levels and Clinical Significance of Serum miR-450a-5p and CREB in Patients with Gestational Diabetes Mellitus

Objective To detect the expression of miR-450a-5p and c-AMP response element binding protein (CREB) in the serum of patients with gestational diabetes (GDM), and explore their clinical significance in the diagnosis of GDM. Methods A total of 120 pregnant women with GDM who were filed in Rugao People’s Hospital from April 2018 to April 2020 were selected as the GDM group, and 120 healthy pregnant women during the same period were selected as the control group. Real-time fluorescent quantitative PCR (qRT-PCR) method was used to detect the level of miR-450a-5p in the serum of subjects. Enzymelinked immunosorbent (ELISA) method was used to detect the expression level of CREB in the serum of subjects. Pearson method was used to analyze the correlation between serum miR-450a-5p and CREB levels and clinicopathological characteristics of GDM pregnant women. Receiver operating characteristic (ROC) curve was used to analyze the expression levels of serum miR-450a-5p and CREB for the diagnostic value of GDM and Logistic regression was used to analyze the influencing factors of GDM. Results Compared with the control group, the serum miR-450a-5p expression level (0.69±0.15 vs 1.58±0.34) in the GDM group was significantly down-regulated (t=26.235, P ＜ 0.05), and the serum CREB expression level (8.75±2.42μg/ml vs 2.64±0.66μg/ml) was significantly up-regulated (t=26.683, P ＜ 0.05)，the differences were statistically significant， respectively. The serum miR-450a-5p level was negatively correlated with fasting blood glucose (FBG) and insulin resistance index (HOMA-IR) (r=-0.427，-0.251, P=0.027，0.015), and positively correlated with fasting insulin (FINS) (r=0.636,P=0.005).The CREB level was positively correlated with FBG and HOMA-IR(r=0.432，0.574，P=0.041，0.008), and negatively correlated with fasting insulin (FINS) (r=-0.573，P=0.028)，the differences were statistically significant， respectively. The ROC curve showed that the area under the curve of serum miR-450a-5p and CREB levels for GDM diagnosis was 0.926 (sensitivity and specificity of 91.7%, 90.8%) and 0.881 (sensitivity and specificity of 86.7%, 89.2%), respectively. Logistic regression analysis showed that miR-450a-5p was a protective factor for GDM, and serum CREB was an independent risk factor for GDM. Conclusion MiR-450a-5p and CREB were significantly abnormally expressed in the serum of GDM patients, and were related to insulin resistance. The detection of serum miR-450a-5p and CREB has important reference value for the clinical diagnosis of GDM.