关键词:

妊娠期糖尿病, 糖脂代谢, 核因子‐κB抑制物激酶ε, 脂肪酸结合蛋白4, 妊娠结局, 影响因素

Abstract:

Objective　To explore the relationship of nuclear factors-κB inhibitor kinase ε (IKKε) and fatty acid binding protein 4 (FABP4) with glucose and lipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). Methods　One hundred and twenty-five patients with GDM confirmed by prenatal examinations at Xi'an Gaoxin Hospital from June 2020 to December 2023 were selected. They were 22-36 (28.77±3.02) years old and 24-28 (26.14±0.87) weeks pregnant. The serum levels IKKε and FABP4 and glucose and lipid metabolism indicators in all the patients were detected. According to the pregnancy outcomes, the patients were divided into a good pregnancy group (92 cases) and a poor pregnancy group (33 cases). The correlations of serum IKK εand FABP4 with glucose and lipid metabolism in the patients were analyzed using the Pearson's method. The factors influencing the pregnancy outcomes in the patients were analyzed using the logistic regression. The predictive values of serum IKKε and FABP4 on pregnancy outcomes in the patients were analyzed using the receiver operating characteristic curves (ROC). t and χ² tests were applied. Results　The levels of IKKε, FABP4, fasting blood glucose (FBG), glycosylated hemoglobin type A1C (HbAlc), triglycerides (TG), and total cholesterol (TC) in the good pregnancy group were higher than those in the good pregnancy group (all P<0.05). The Pearson's analysis showed that the serum levels of IKK ε and FABP4 were positively correlated with FBG, HbAlc, TG, and TC (r=0.543, 0.621, 0.354, 0.312, 0.705, 0.658, 0.433, and 0.365; all P<0.05). The multivariate logistic regression analysis showed that IKK ε (OR=3.287, 95%CI 1.994-5.418), FABP4 (OR=3.942, 95%CI 1.754-8.856), FBG (OR=2.857, 95%CI 1.416-5.762), and TC (OR=4.133, 95%CI 2.190-7.799) were independent risk factors for adverse pregnancy outcomes in the patients (all P<0.05). The ROC displayed that the sensitivities of serum IKK ε, FABP4, and their combination in predicting pregnancy outcomes in the patients was 72.70%, 75.80%, and 90.90%; the specificities were 73.90%, 71.70%, and 91.30%; the areas under curves (AUC) were 0.802, 0.829, and 0.923 (all P<0.05). Conclusions　Serum IKK εFABP4 in patients with GDM are positively correlated with glucose and lipid metabolism indicators, such as FBG, HbAlc, TG, and TC. Serum IKKε and FABP4 are independent risk factors for adverse pregnancy in patients with GDM. IKKε and FABP4 can effectively predict pregnancy outcomes in patients with GDM.

Key words:

Gestational diabetes mellitus, Glucose and lipid metabolism, Nuclear factors-κB inhibitor kinase ε, Fatty acid binding protein 4,  , Pregnancy outcomes, Influencing factors