早孕期血清SHBG水平与妊娠期糖尿病发病的关系

目的:探讨早孕期血清性激素结合球蛋白(sexhormonebindingglobulin,SHBG)水平与妊娠期糖尿病(gesta-tionaldiabetesmellitus,GDM)发病关系。方法:采用ELISA法分别测定GDM发病期和早孕(妊娠10+1～12周)期的孕妇血清SHBG水平并进行分析。结果:早孕期血清SHBG水平与GDM发病时间Spearman等级相关,r=0.9739。Logistic多元回归分析结果表明早孕期血清SHBG水平作为连续性变量每升高50nmol/L,GDM危险下降53%(OR及95%CI:0.474,0.306～0.736);以中位数(Median)将早孕期血清SHBG水平分为二分类变量,结果表明SHBG≤407.8nmol/L相对于SHBG407.8nmol/L发展成GDM危险增加(OR及95%CI:3.615,2.195～5.956)。结论:早孕期血清SHBG水平降低明显预示着将来GDM发病的可能;早孕期血清SHBG水平降低程度不但可以作为早期预测GDM发病一个指标,而且还可以判定GDM发病的时间和程度。

Researches on the association between sex hormone binding globulin levels in the first trimester of pregnancy and subsequent gestational diabetes mellitus

Objective:To investigate the association between sex hormone binding globulin levels in the first trimester and subsequent gestational diabetes mellitus.Methods:The serum SHBG levels of GDM onset and first trimester of pregnancy (gestational weeks 10 +1-12) were examined and analyzed separately by ELISA assay.Results:There was a significant correlation between SHBG levels of the first trimester and the time of consequent GDM (r=0.973 9,P < 0.000 1).The results of multi variable analysis with logistic regression suggested that the risk of GDM decreased by 53% when the SHBG levels of the first trimester as a continuous variance increased by 50 nmol/L (OR=0.474,95% CI=0.306-0.736).SHBG levels for the first trimester of pregnancy were analyzed as a binary variable separated by median.The results showed that the risk of GDM increased when the level of SHBG ≤407.8 nmol/L compared with SHBG > 407.8 nmol/L (OR=3.615,95% CI=2.195-5.956).Conclusion:Decreased serum SHBG levels of the first trimester will obviously prognose the possibility of consequent GDM in the second and third trimester.The degree for the decreasing of SHGB levels in the first trimester is not only predict early the GDM morbility,but also assess the onset time and degree of GDM.