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

摘要：

目的　探究核因子-κB抑制物激酶ε（IKKε）、脂肪酸结合蛋白4（FABP4）与妊娠期糖尿病（GDM）患者糖脂代谢水平和妊娠结局的关系。方法　回顾性选取2020年6月至2023年12月在西安高新医院进行产检确诊GDM的患者125例。年龄22～36（28.77±3.02）岁；确诊孕周为24～28（26.14±0.87）周。患者均进行血清IKKε、FABP4水平及糖脂代谢指标检测，根据患者妊娠结局将其分为妊娠良好组（92例）和妊娠不良组（33例）。Pearson法分析血清IKKε、FABP4与患者糖脂代谢的相关性，logistic回归分析患者妊娠结局的影响因素，采用受试者操作特征曲线（ROC）分析血清IKKε、FABP4水平对患者妊娠结局的预测价值。统计学方法采用t检验、χ²检验。结果　妊娠不良组IKKε、FABP4、空腹血糖（FBG）、糖化血红蛋白（HbAlc）、甘油三酯（TG）、总胆固醇（TC）水平均高于妊娠良好组（均P<0.05）。Pearson法显示，血清IKKε、FABP4水平与FBG、HbAlc、TG、TC均呈正相关（r=0.543、0.621、0.354、0.312、0.705、0.658、0.433、0.365，均P<0.05）。多因素logistic回归分析显示，IKKε（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）、TC（OR=4.133，95%CI 2.190～7.799）是患者不良妊娠结局的独立危险因素（均P<0.05）。ROC显示，血清IKKε、FABP4、二者联合预测患者妊娠结局的敏感度分别为72.70%、75.80%、90.90%，特异度分别为73.90%、71.70%、91.30%，AUC分别为0.802、0.829、0.923（均P<0.05）。结论　GDM患者血清IKKε、FABP4与糖脂代谢指标FBG、HbAlc、TG、TC水平均呈正相关，且血清IKKε、FABP4是影响患者不良妊娠的独立危险因素，通过联合测定IKKε与FABP4水平可有效预测患者妊娠结局。

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