妊娠糖尿病患者血清TXNIP、C-P水平对胎儿生长受限的预测价值

Predictive value of serum TXNIP and C-peptide levels for fetal growth restriction in gestational diabetes mellitus

摘要:

目的 分析妊娠糖尿病（GDM）患者血清硫氧还蛋白相互作用蛋白（TXNIP）和C肽（C-P）水平对胎儿生长受限（FGR）的预测价值。方法 选取2021年1月—2024年1月西安市人民医院收治的86例GDM患者为研究对象，设为观察组；从同期该院产检健康的孕妇中选取93例作为对照组。收集两组的临床资料，并检测研究对象的血清TXNIP、C-P水平。根据观察组的妊娠结局，将其分为FGR组与非FGR组，比较两组血清TXNIP、C-P水平。采用多因素逐步Logistic回归模型分析血清TXNIP和C-P水平对GDM患者发生FGR的影响，绘制受试者工作特征（ROC）曲线评估血清TXNIP、C-P水平对FGR的预测价值。结果 FGR组血清TXNIP和C-P水平均高于非FGR组（P <0.05）；多因素逐步Logistic分析结果显示，血清TXNIP水平高［O^R =1.159（95% CI：1.056，1.273）］、C-P水平高［O^R =4.957（95% CI：1.633，15.044）］均为发生FGR的危险因素（P <0.05）；ROC曲线结果显示，血清TXNIP和C-P水平联合检测评估GDM患者发生FGR的敏感性为82.1%（95% CI ：0.631，0.939），特异性为81.0%（95% CI ：0.686，0.901）。结论 GDM患者血清TXNIP和C-P水平升高与FGR风险增加相关，联合检测可提高对FGR的预测价值。

Abstract:

Objective To analyze the predictive value of serum thioredoxin-interacting protein (TXNIP) and C-peptide (C-P) levels for fetal growth restriction (FGR) in gestational diabetes mellitus (GDM) patients.Methods Eighty-six GDM patients admitted from January 2021 to January 2024 were enrolled as observation group; ninety-three healthy pregnant women from the same period served as controls. Clinical data were collected, and serum TXNIP/C-P levels were measured. Based on pregnancy outcomes, the observation group was divided into FGR and non-FGR subgroups for TXNIP/C-P level comparison. Multivariate stepwise logistic regression analyzed TXNIP/C-P impact on FGR risk. Receiver operating characteristic (ROC) curves evaluated predictive value.Results FGR subgroup exhibited higher serum TXNIP and C-P levels versus non-FGR subgroup (P < 0.05). Elevated TXNIP [O^R = 1.159 (95% CI: 1.056, 1.273) ] and C-P [O^R = 4.957 (95% CI: 1.633, 15.044) ] were independent FGR risk factors (P < 0.05). Combined TXNIP/C-P detection predicted FGR with sensitivity = 82.1% (95% CI: 0.631, 0.939) and specificity = 81.0% (95% CI: 0.686, 0.901).Conclusion Elevated serum TXNIP and C-P levels correlate with increased FGR risk in GDM patients. Combined detection enhances predictive accuracy.