妊娠期糖尿病患者血清microRNA-122联合microRNA-7047-5p预测不良围生儿结局价值

The value of serum microRNA-122 combined with microRNA-7047-5p in predicting adverse perinatal outcomes in patients with gestational diabetes mellitus

摘要:

目的 探讨妊娠期糖尿病患者血清microRNA-122（miR-122）联合microRNA-7047-5p（miR-7047-5p）预测不良围生儿结局价值。方法 选取2018年4月—2023年4月亳州市人民医院接收的100例妊娠期糖尿病患者作为观察组，选取同期该院孕检的90例健康孕妇作为对照组。检测两组血糖水平、血清miR-122、miR-7047-5p，采用Pearson法分析评估血清miR-122、miR-7047-5p水平与血糖水平的相关性；根据随访结果将观察组围生儿结局分为良好组（85例）与不良组（15例），比较两组血清miR-122、miR-7047-5p相对表达量，构建受试者工作特征（ROC）曲线评估血清miR-122、miR-7047-5p联合预测妊娠期糖尿病患者不良围生儿结局的价值。结果 观察组空腹血糖（FBG）、2 h餐后血糖（2 hPG）、糖化血红蛋白（HbA1c）水平高于对照组（P <0.05）。观察组miR-122相对表达量高于对照组（P <0.05），miR-7047-5p相对表达量低于对照组（P <0.05）。Pearson相关性分析结果显示，miR-122与FBG、2hPG、HbA1c均呈正相关（r =0.167、0.228和0.255，均P <0.05），miR-7047-5p与FBG、2 hPG、HbA1c均呈负相关（r =-0.358、-0.408和-0.386，均P <0.05）。不良组miR-122相对表达量高于良好组（P <0.05），miR-7047-5p相对表达量低于良好组（P <0.05）。ROC曲线分析结果显示，血清miR-122和miR-7047-5p联合预测GDM患者不良围生儿结局的敏感性为73.3%（95% CI：0.449，0.922），特异性为85.9%（95% CI：0.766，0.925），曲线下面积为0.836（95% CI：0.720，0.952）。结论 在妊娠期糖尿病患者中，血清microRNA-122和microRNA-7047-5p与血糖水平相关，且两者联合检测可以有效预测GDM患者的不良围生儿结局，具有较高的预测敏感性和特异性。

Abstract:

Objective To explore the value of serum microRNA-122 (miR-122) combined with microRNA-7047-5p (miR-7047-5p) in predicting adverse perinatal outcomes in patients with gestational diabetes mellitus (GDM).Methods The study included 100 GDM patients admitted to Bozhou People's Hospital from April 2018 to April 2023 as the observation group. Meanwhile, 90 healthy pregnant women undergoing routine prenatal care checkups during the same period were selected as the control group. The levels of blood glucose and serum miR-122 and miR-7047-5p were measured in both groups. Pearson correlation analysis was performed to determine the correlation between serum levels of miR-122 and miR-7047-5p and the level of blood glucose. Based on follow-up results of perinatal outcomes, the observation group was further classified into good (85 cases) and poor (15 cases) groups. Serum levels of miR-122 and miR-7047-5p were compared between the two subgroups. The receiver operating characteristic (ROC) curves were constructed to assess the value of serum miR-122 combined with miR-7047-5p in predicting adverse perinatal outcomes in GDM patients.Results The levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 hPG), and glycosylated hemoglobin (HbA1c) in the observation group were higher than those in the control group (P < 0.05). The relative expression of serum miR-122 was higher (P <0.05), and that of miR-7047-5p was lower in the observation group compared with the control group (P < 0.05). The Pearson correlation analysis showed that the level of miR-122 was positively correlated with levels of FBG, 2 hPG, and HbA1c (r =0.167, 0.228 and 0.255, P < 0.05), while the level of miR-7047-5p was negatively correlated with levels of FBG, 2 hPG, and HbA1c (r =-0.358, -0.408 and -0.386, P < 0.05). In the poor group, the relative expression of miR-122 was higher (P < 0.05) and that of miR-7047-5p was lower than in the good group (P < 0.05). ROC curve analysis revealed that the combined detection of serum miR-122 and miR-7047-5p for predicting adverse perinatal outcomes in GDM patients yielded a sensitivity of 73.3% (95% CI: 44.9%, 92.2%) and a specificity of 85.9% (95% CI: 76.6%, 92.5%), with an area under the curve (AUC) of 0.836 (95% CI: 0.720, 0.952).Conclusions In GDM patients, serum levels of miR-122 and miR-7047-5p are associated with the levels of blood glucose. Besides, the combined detection of these two miRNAs effectively predicts adverse perinatal outcomes in GDM patients, with high predictive sensitivity and specificity.