妊娠糖尿病患者血清白脂素的表达及其与糖脂代谢的相关性研究

李思曼; 陈娟; 张文杰

doi:10.16766/j.cnki.issn.1674-4152.003904

妊娠糖尿病患者血清白脂素的表达及其与糖脂代谢的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.003904

1.
西北妇女儿童医院妇女保健科，陕西西安 710061
2.
咸阳市第一人民医院产科，陕西咸阳 712000

基金项目:

陕西省重点研发计划项目 2022SF-277

详细信息

通讯作者:
陈娟，E-mail：yytthxq@126.com

中图分类号: R714.256
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- 文章访问数: 4
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- 被引次数: 0
出版历程
- 收稿日期: 2024-04-12
- 网络出版日期: 2025-05-14

Expression of serum asprosin in patients with gestational diabetes mellitus and its correlation with glucose and lipid metabolism

1.
Department of Women's Health Care, Northwest Women and Children's Hospital, Xi'an, Shaanxi 710061, China

摘要

摘要: 目的探讨妊娠糖尿病(GDM)患者血清白脂素是否存在异常表达，并分析其与糖脂代谢指标的关系，为分析GDM的发病机制提供新思路。方法选取2020年4月—2021年4月西北妇女儿童医院收治的86例GDM患者(GDM组)和50例健康孕妇(对照组)。GDM患者根据血清白脂素中位数水平分为高表达组(44例)和低表达组(42例)。检测糖脂代谢指标和白脂素水平，分析白脂素与其他指标的相关性，采用多因素logistic回归分析研究GDM的危险因素。结果 GDM组血清白脂素水平[(2.56±0.61)ng/mL]高于对照组[(1.12±0.43)ng/mL, P＜0.05]。GDM患者血清白脂素与三酰甘油、总胆固醇、空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)均呈正相关关系(r=0.312、0.327、0.403、0.462、0.518，均P＜0.05)。多因素logistic回归分析显示，FBG(OR=3.216，95% CI：1.434~7.210)、FINS(OR=2.869，95% CI：1.395~5.902)、HOMA-IR(OR=3.511，95% CI：1.456~8.466)、白脂素(OR=2.659，95% CI：1.295~7.003)水平过高均是GDM的危险因素(P＜0.05)。结论 GDM患者血清白脂素呈高表达，且与患者糖脂代谢水平密切相关。
- 妊娠糖尿病 /
- 白脂素 /
- 胰岛素抵抗 /
- 脂代谢 /
- 糖代谢
Abstract: Objective To investigate whether there is abnormal expression of serum asprosin in patients with gestational diabetes mellitus (GDM), and to analyze its relationship with glycolipid metabolism indexes, so as to provide new ideas for the pathogenesis of GDM. Methods A total of 86 GDM patients (GDM group) and 50 healthy pregnant women (control group) were selected from Northwest Women and Children's Hospital from April 2020 to April 2021. GDM patients were divided into a high-expression group (n=44) and a low-expression group (n=42). Glucose and lipid metabolism indexes and serum asprosin level were detected, the correlation between serum asprosin and other indexes was analyzed, and the risk factors of GDM were analyzed by multi-factor logistic regression. Results The level of serum asprosin in the GDM group [(2.56±0.61) ng/mL] was higher than that in the control group [(1.12±0.43) ng/mL, P < 0.05]. Serum asprosin were positively correlated with triacylglycerol, total cholesterol, fasting blood glucose (FBG), fasting insulin (FINS), and insulin resistance index (HOMA-IR) in GDM patients (r=0.312, 0.327, 0.403, 0.462, 0.518, all P < 0.05). High levels of FBG (OR=3.216, 95% CI: 1.434-7.210), FINS (OR=2.869, 95% CI: 1.395-5.902), HOMA-IR (OR=3.511, 95% CI: 1.456-8.466), serum asprosin (OR=2.659, 95% CI: 1.295-7.003) were risk factors for GDM (P < 0.05). Conclusion The high expression of serum asprosin in patients with GDM is closely related to the level of glucose and lipid metabolism.
- Gestational diabetes mellitus /
- Asprosin /
- Insulin resistance /
- Lipid metabolism /
- Glucose metabolism

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表 1 GDM组和对照组相关指标比较(x ±s)

Table 1. Comparison of related indicators between GDM group and control group(x ±s)

组别	例数	收缩压(mmHg)	舒张压(mmHg)	三酰甘油(mmol/L)	总胆固醇(mmol/L)	LDL-C(mmol/L)	HDL-C(mmol/L)	FBG(mmol/L)	FINS(μU/mL)	HOMA-IR	白脂素(ng/mL)
对照组	50	115.89±10.38	81.42±7.11	1.68±0.41	4.49±0.71	2.79±0.62	1.86±0.38	4.51±0.42	9.98±1.32	2.00±0.36	1.12±0.43
GDM组	86	118.92±12.79	82.87±6.94	1.87±0.43	5.09±0.82	3.16±0.68	1.78±0.42	5.42±0.38	14.98±2.67	3.61±0.67	2.56±0.61
t值		1.424	1.164	2.527	4.317	3.159	1.108	12.951	12.378	15.708	14.694
P值		0.157	0.246	0.013	＜0.001	0.002	0.270	＜0.001	＜0.001	＜0.001	＜0.001
注：1 mmHg=0.133 kPa。

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表 2 不同白脂素表达水平GDM患者相关指标比较(x ±s)

Table 2. Comparison of related indicators of GDM patients with different asprosin expression levels(x ±s)

组别	例数	收缩压(mmHg)	舒张压(mmHg)	三酰甘油(mmol/L)	总胆固醇(mmol/L)	LDL-C(mmol/L)	HDL-C(mmol/L)	FBG(mmol/L)	FINS(μU/mL)	HOMA-IR
高表达组	44	119.12±12.91	83.42±7.02	1.98±0.45	5.36±0.78	3.21±0.71	1.75±0.41	5.53±0.39	16.14±2.78	3.97±0.65
低表达组	42	118.71±12.46	82.29±6.28	1.75±0.41	4.81±0.83	3.11±0.65	1.81±0.44	5.31±0.28	13.76±2.42	3.25±0.68
t值		0.150	0.785	2.474	3.168	0.680	0.655	2.993	4.226	5.020
P值		0.881	0.434	0.015	0.002	0.498	0.515	0.004	＜0.001	＜0.001

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表 3 GDM患者血清白脂素与其他指标的相关性分析

Table 3. Correlation analysis of serum asprosin and other indicators in GDM patients

项目	收缩压	舒张压	三酰甘油	总胆固醇	LDL-C	HDL-C	FBG	FINS	HOMA-IR
r值	0.089	0.102	0.312	0.327	0.154	-0.094	0.403	0.462	0.518
P值	0.426	0.367	0.004	＜0.001	0.268	0.401	＜0.001	＜0.001	＜0.001

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表 4 GDM的危险因素分析

Table 4. Analysis of risk factors for GDM

变量	B	SE	Waldχ²	P值	OR值	95% CI
FBG	1.168	0.412	8.037	0.005	3.216	1.434~7.210
FINS	1.054	0.368	8.203	0.004	2.869	1.395~5.902
HOMA-IR	1.256	0.449	7.825	0.005	3.511	1.456~8.466
白脂素	0.978	0.367	7.101	0.008	2.659	1.295~7.003

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参考文献(21)

[1]	RASMUSSEN L, POULSEN C W, KAMPMANN U, et al. Diet and healthy lifestyle in the management of gestational diabetes mellitus[J]. Nutrients, 2020, 12(10): 3050. DOI: 10.3390/nu12103050.
[2]	吴佳丽, 甘文佳, 冯品宁. 孕期血脂指标与妊娠期糖尿病及新生儿脐血C肽的相关性研究[J]. 新医学, 2023, 54(7): 517-521. WU J L, GAN W J, FENG P N. Study of the correlation between serum lipid parameters during pregnancy and gestational diabetes mellitus and neonatal cord-blood C-peptide[J]. Journal of New Medicine, 2023, 54(7): 517-521.
[3]	SHARMA A K, SINGH S, SINGH H, et al. Deep insight of the pathophysiology of gestational diabetes mellitus[J]. Cells, 2022, 11(17): 2672. DOI: 10.3390/cells11172672.
[4]	史晓娟, 李东风, 张小伟. 妊娠前三酰甘油/高密度脂蛋白胆固醇值联合胱抑素C预测妊娠期糖尿病的价值[J]. 中华全科医学, 2024, 22(2): 269-272. doi: 10.16766/j.cnki.issn.1674-4152.003381 SHI X J, LI D F, ZHANG X W. Predictive value of pregestational TG/HDL-C ratio combined with cystatin C in predicting gestational diabetes in pregnant women[J]. Chinese Journal of General Practice, 2024, 22(2): 269-272. doi: 10.16766/j.cnki.issn.1674-4152.003381
[5]	MOYCE GRUBER B L, DOLINSKY V W. The role of adiponectin during pregnancy and gestational diabetes[J]. Life (Basel), 2023, 13(2): 301. DOI: 10.3390/life13020301.
[6]	ZHANG H, HU W, ZHANG G. Circulating asprosin levels are increased in patients with type 2 diabetes and associated with early-stage diabetic kidney disease[J]. Int Urol Nephrol, 2020, 52(8): 1517-1522. doi: 10.1007/s11255-020-02509-8
[7]	HOFFMANN T, MORCOS Y, JANOSCHEK R, et al. Correlation of metabolic characteristics with maternal, fetal and placental asprosin in human pregnancy[J]. Endocr Connect, 2022, 11(3): e220069. DOI: 10.1530/EC-22-0069.
[8]	中华医学会妇产科学分会产科学组, 中华医学会围产医学分会妊娠合并糖尿病协作组. 妊娠合并糖尿病诊治指南(2014)[J]. 中华妇产科学杂志, 2014, 49(8): 561-569. Obstetrics Group, Chinese Society of Obstetrics and Gynecology, Chinese Society of Perinatal Medicine, Pregnancy and Diabetes Cooperation Group. Guidelines for Diagnosis and Treatment of gestational Diabetes Mellitus (2014)[J]. Chinese Journal of Obstetrics and Gynecology, 2014, 49(8): 561-569.
[9]	HOFFMANN J G, XIE W, CHOPRA A R. Energy regulation mechanism and therapeutic potential of asprosin[J]. Diabetes, 2020, 69(4): 559-566. doi: 10.2337/dbi19-0009
[10]	MAZUR-BIALY A I. Asprosin-a fasting-induced, glucogenic, and orexigenic adipokine as a new promising player. Will it be a new factor in the treatment of obesity, diabetes, or infertility? A review of the literature[J]. Nutrients, 2021, 13(2): 620. DOI: 10.3390/nu13020620.
[11]	ZHANG X Y, JIANG H, MA X J, et al. Increased serum level and impaired response to glucose fluctuation of asprosin is associated with type 2 diabetes mellitus[J]. J Diabetes Investig, 2020, 11(2): 349-355. doi: 10.1111/jdi.13148
[12]	GOZEL N, KILINC F. Investigation of plasma asprosin and saliva levels in newly diagnosed type 2 diabetes mellitus patients treated with metformin[J]. Endokrynol Pol, 2021, 72(1): 37-43. doi: 10.5603/EP.a2020.0059
[13]	许瀚元, 朱惠娟, 龚凤英. 白脂素: 一种新型的脂肪细胞因子[J]. 国际内分泌代谢杂志, 2018, 38(6): 401-404. XU H Y, ZHU H J, GONG F Y. Asprosin: a newly identified adipokine[J]. International Journal of Endocrinology and Metabolism, 2018, 38(6): 401-404.
[14]	LI E W, SHAN H L, CHEN L Q, et al. OLFR734 mediates glucose metabolism as a receptor of asprosin[J]. Cell Metab, 2019, 30(2): 319-328. e8. doi: 10.1016/j.cmet.2019.05.022
[15]	BAYKUS Y, YAVUZKIR S, USTEBAY S, et al. Asprosin in umbilical cord of newborns and maternal blood of gestational diabetes, preeclampsia, severe preeclampsia, intrauterine growth retardation and macrosemic fetus[J]. Peptides, 2019, 120: 170132. DOI: 10.1016/j.peptides.2019.170132.
[16]	ZHANG L, CHEN C, ZHOU N, et al. Circulating asprosin concentrations are increased in type 2 diabetes mellitus and independently associated with fasting glucose and triglyceride[J]. Clin Chim Acta, 2019, 489: 183-188. doi: 10.1016/j.cca.2017.10.034
[17]	WANG M, YIN C Y, WANG L, et al. Serum asprosin concentrations are increased and associated with insulin resistance in children with obesity[J]. Ann Nutr Metab, 2019, 75(4): 205-212. doi: 10.1159/000503808
[18]	DUERRSCHMID C, HE Y L, WANG C M, et al. Asprosin is a centrally acting orexigenic hormone[J]. Nat Med, 2017, 23(12): 1444-1453. doi: 10.1038/nm.4432
[19]	LEE T, YUN S, JEONG J H, et al. Asprosin impairs insulin secretion in response to glucose and viability through TLR4/JNK-mediated inflammation[J]. Mol Cell Endocrinol, 2019, 486: 96-104. doi: 10.1016/j.mce.2019.03.001
[20]	SÜNNETÇI SILISTRE E, HATIPOĞL H U. Increased serum circulating asprosin levels in children with obesity[J]. Pediatr Int, 2020, 62(4): 467-476. doi: 10.1111/ped.14176
[21]	WANG C Y, LIN T A, LIU K H, et al. Serum asprosin levels and bariatric surgery outcomes in obese adults[J]. Int J Obes (Lond), 2019, 43(5): 1019-1025. doi: 10.1038/s41366-018-0248-1