目的 观察妊娠期糖尿病(GDM)患者血清抑制素A(INHA)、糖化分化簇59(GCD59)水平变化,并分析其对不良妊娠结局的预测效能.方法 GDM孕妇97例(观察组)、同期健康孕妇100例(对照组),采用酶联免疫吸附法检测两组血清INHA、GCD59;根据是否发生不良妊娠结局将观察组分为不良组(31例)和良好组(66例),采用单因素和多因素Logistic回归分析法分析GDM患者不良妊娠结局的影响因素;绘制ROC,分析血清INHA、GCD59水平对GDM患者不良妊娠结局的预测效能.结果 与对照组比较,观察组血清INHA、GCD59水平升高(P均<0.05).不良组和良好组INHA、GCD59、HbA1C、HOMA-IR比较,P均<0.05;INHA、GCD59、HOMA-IR升高为GDM患者不良妊娠结局的独立危险因素(P均<0.05).血清INHA水平预测GDM患者不良妊娠结局的最佳截断值为1 209.95 pg/mL,曲线下面积(AUC)为0.788(0.693~0.864),灵敏度、特异度、Youden指数分别为90.32%、59.09%、0.494;血清GCD59水平预测GDM患者不良妊娠结局的最佳截断值为3.60 ng/mL,AUC为0.785(0.690~0.862),灵敏度、特异度、Youden指数分别为90.30%、51.52%、0.418;血清INHA、GCD59水平联合预测GDM患者不良妊娠结局的AUC为0.897(0.819~0.949),灵敏度、特异度、Youden指数分别为83.97%、89.39%、0.733.结论 GDM患者血清INHA、GCD59水平升高,是GDM患者不良妊娠结局的危险因素,检测两指标有助于GDM患者不良妊娠结局的预测.
Objective To observe the changes of serum inhibin A(INHA)and glycated cluster of differentiation 59(GCD59)levels in patients with gestational diabetes mellitus(GDM),and to analyze their predictive efficacy for adverse pregnancy outcomes.Methods Ninety-seven pregnant women with GDM(observation group)and 100 healthy pregnant women in the same period(control group)were selected.The serum INHA and GCD59 levels in both groups were detected by enzyme-linked immunosorbent assay.According to the occurrence of adverse pregnancy outcome,the observation group was divided into adverse group(31 cases)and good group(66 cases).Univariate and multivariate Logistic regression anal-yses were used to analyze the influencing factors of adverse pregnancy outcome in pregnant women with GDM.Receiver op-erating characteristic(ROC)curve was drawn to analyze the predictive efficacy of serum INHA and GCD59 levels for ad-verse pregnancy outcomes in GDM patients.Results Compared with the control group,serum INHA and GCD59 levels increased in the observation group(both P<0.05).Significant differences were found in the INHA,GCD59,HbA1c,and HOMA-IR between the adverse group and the good group(all P<0.05).Elevated INHA,GCD59,and HOMA-IR were in-dependent risk factors for adverse pregnancy outcomes in patients with GDM(all P<0.05).The best cut-off value of serum INHA level in predicting adverse pregnancy outcome in GDM patients was 1 209.95 pg/mL,and the area under the curve(AUC)was 0.788(0.693-0.864),the sensitivity,specificity,and Youden index were 90.32%,59.09%,and 0.494,respectively.The best cut-off value of serum GCD59 level in predicting adverse pregnancy outcomes in GDM patients was 3.60 ng/mL,AUC was 0.785(0.690-0.862),sensitivity,specificity,and Youden index were 90.30%,51.52%,and 0.418,respectively.The AUC of serum INHA and GCD59 levels in predicting the adverse pregnancy outcomes in GDM patients was 0.897(0.819 to 0.949),and the sensitivity,specificity,and Youden index were 83.97%,89.39%,and 0.733,respectively.Conclusion Elevated serum INHA and GCD59 levels in patients with GDM are risk factors for ad-verse pregnancy outcome in patients with GDM,and detection of the two indicators is helpful in predicting the adverse preg-nancy outcome in patients with GDM.