目的: 探讨妊娠期糖尿病(GDM)孕妇血清miRNA-137表达与新生儿高胆红素血症的关系。方法: 以2018年6月至2019年6月入院的73例GDM孕妇作为GDM组进行回顾性研究, 另选取80例分娩孕周相匹配但无GDM的孕妇作为对照组。收集两组临床资料, 采用实时定量荧光PCR法测定孕妇血清和胎盘miR-137的表达, 利用受试者工作特征(ROC)曲线预测GDM孕妇血清miR-137表达对新生儿高胆红素血症的诊断价值。结果: 与对照组比较, GDM组血清、胎盘miR-137表达水平显著升高(P < 0.05)。Pearson相关分析显示, GDM组孕妇血清和胎盘组织样本中miR-137表达呈正相关(r=0.623, P < 0.05)。GDM组中23例新生儿高胆红素血症(高胆红素血症组)的孕妇血清miR-137表达水平高于非高胆红素血症组(2.12±0.79 vs. 1.13±0.31, P < 0.05)。Pearson相关分析显示, GDM组孕妇血清样本中miR-137表达水平与新生儿血清胆红素水平呈正相关(r=0.378, P < 0.05)。单因素和多因素Logistic分析显示, 孕妇吸烟史、巨大儿、新生儿Apgar 5 min评分 < 7分、孕妇血清miR-137水平都是影响新生儿高胆红素血症的独立危险因素。ROC曲线分析显示, GDM孕妇血清miR-137预测新生儿高胆红素血症的曲线下面积(AUC)为0.904(0.825, 0.983), 截断值为1.685, 在该截断值下灵敏度为0.739, 特异度为0.947。结论: GDM孕妇血清miR-137表达水平明显上调, 而且这也是新生儿高胆红素血症发生的独立危险因素。 |
Objective: To study the relationship between serum miRNA-137 expression in pregnant women with gestational diabetes mellitus (GDM) and neonatal hyperbilirubinemia.Methods: A retrospective study was conducted on 73 pregnant women with GDM admitted to the hospital from June 2018 to June 2019 as the GDM group. Another 80 pregnant women with matching gestational weeks but without GDM during pregnancy were selected as the control group. The clinical data of all subjects were collected, and the real-time quantitative fluorescent PCR was used to determine the expression of miR-137 in maternal serum and placenta. Receiver operating characteristics (ROC) curve was used to predict the diagnostic value of serum miR-137 expression in pregnant women with GDM for neonatal hyperbilirubinemia.Results: Compared with the control group, the serum and placental miR-137 levels in the GDM group were significantly increased (P < 0.05). Pearson correlation analysis showed, the expression of miR-137 in serum and placental tissue samples of pregnant women in GDM group was positively correlated (r=0.623, P < 0.05). The expression level of maternal serum miR-137 in 23 neonates with hyperbilirubinemia in the GDM group was higher than that in the non-hyperbilirubinemia group (2.12±0.79 vs. 1.13±0.31, P < 0.05). The expression level of miR-137 in the serum samples of pregnant women in the GDM group was positively correlated with the serum bilirubin level (r=0.378, P < 0.05). Univariate and multivariate Logistic analysis showed that pregnant women's smoking history, macrosomia, neonatal Apgar 5 min score < 7 after birth of newborns, and higher maternal serum miR-137 levels were all independent risk factors affecting neonatal hyperbilirubinemia. By ROC curve analysis, the area under the curve (AUC) of GDM pregnant women's serum miR-137 for predicting neonatal hyperbilirubinemia was 0.904 (0.825, 0.983), the cut-off value was 1.685, the sensitivity was 0.739 and the specificity was 0.947 at this cut-off value.Conclusion: The expression level of serum miR-137 in pregnant women with GDM is significantly up-regulated, and this is also an independent risk factor for neonatal hyperbilirubinemia. |
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