河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (9): 1042-1046.doi: 10.3969/j.issn.1007-3205.2022.09.011

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妊娠期糖尿病患者血清GLP-1及胎盘组织中IGF-1R与新生儿结局的关系

  

  1. 南京医科大学附属江苏盛泽医院产科，江苏 苏州 215000

  • 出版日期:2022-09-25 发布日期:2022-10-02
  • 作者简介:邵婕（1983-）,女,苏州吴江人，南京医科大学附属江苏盛泽医院副主任医师，医学学士，从事高危妊娠及孕产康复研究。
  • 基金资助:
    苏州市吴江区“科教兴卫”项目（wwk201813）

The relationship between serum GLP-1 and IGF-1R in placental tissues and neonatal outcome in patients with gestational diabetes

  1. Department of Obstetrics, Jiangsu Shengze Hospital Affiliated to Nanjing Medical University, Suzhou 215000, China

  • Online:2022-09-25 Published:2022-10-02

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摘要： 目的 研究妊娠期糖尿病（gestational diabetes mellitus，GDM）患者血清胰高血糖素样肽1(glucagon-like peptide 1，GLP-1)及胎盘组织中胰岛素样生长因子 1 受体(insulin 1ike growth factor 1 receptor,IGF-1R）与新生儿结局的关系。
方法 收集产检和孕足月分娩单胎妊娠孕妇，通过妊娠24~28周75 g口服葡萄糖耐量试验（oral glucose tolerance test，OGTT），将其分为GDM组和非GDM组，比较两组体重指数（body mass index，BMI）、年龄、孕周、空腹血糖（fasting plasma glucose，FPG），服糖后1 h血糖（1 h fasting plasma glucose after taking sugar，FPG1）、服糖后2 h血糖(2 h fasting plasma glucose after taking sugar，FPG2)、IGF-1R、糖化血红蛋白（glycosylated hemoglobin，HbA1c）、血清GLP-1情况。同时，探究GLP-1、IGF-1R与新生儿结局的关系以及GLP-1、IGF-1R两者的相关性。
结果  两组患者于孕前BMI、FPG、FPG1、FPG2、IGF-1R、HbA1c、血清GLP-1差异有统计学意义（P＜0.05），但是在年龄、孕周差异无统计学意义（P＞0.05）。GDM组中，不良新生儿结局50例（25.0%），非GDM组不良新生儿结局10例（5%），差异有统计学意义（χ2=31.373，P＜0.001）。GLP-1与不良新生儿结局负向影响关系［β=-0.141，OR=0.869（95%CI：0.821~0.919）］；IGF与不良新生儿结局有正向影响关系［β=0.745，OR=2.107（95%CI：1.214~3.656）］。影响不良新生儿结局的独立危险因素是GDM和IGF-1R。 GLP-1、IGF-1R呈负相关关系（r=-0.478，P＜0.05）。
结论 妊娠期糖尿病患者血清GLP-1负向影响不良新生儿结局，而胎盘组织中IGF-1R正向影响不良新生儿结局。临床需加以注意。


关键词: 糖尿病, 妊娠, 胰高血糖素, 胎盘

Abstract: ObjectiveTo study the relationship between serum glucagon-like peptide-1(GLP-1) and insulin-like growth factor 1 receptor(IGF-1R) in placental tissues and neonatal outcomes in patients with gestational diabetes. 
MethodsPregnant women undergoing pregnancy examination and women with full-term singleton pregnancy in our hospital were enrolled. They underwent 75 g OGTT examination at 24-28 weeks of pregnancy and were divided into GDM group and non-GDM group. Body mass index(BMI), age, gestational age, fasting plasma glucose(FPG), 1 h fasting plasma glucose after taking sugar(FPG1), 2 h fasting plasma glucose after taking sugar(FPG2), IGF-1R, glycosylated hemoglobin(HbA1c), and GLP-1 were compared between the two groups. Meanwhile, the relationship between GLP-1, IGF-1R and neonatal outcomes as well as the correlation between GLP-1 and IGF-1R was explored. 
ResultsThere were significant differences in BMI, FPG, FPG1, FPG2, IGF-1R, HbA1c, and serum GLP-1 between two groups before pregnancy(P＜0.05), but there was no difference in age and gestational age(P＞0.05). In the GDM group, 50 cases(25.0%) had adverse neonatal outcomes, and 10 cases(5%) in the non-GDM group had adverse neonatal outcomes, suggesting significant differences(χ2=31.373, P＜0.001). GLP-1 had a negative impact on adverse neonatal outcomes ［β=-0.141, OR=0.869(95%CI: 0.821-0.919)］, and IGF had a positive impact on adverse neonatal outcomes［β=0.745, OR= 2.107(95%CI: 1.214-3.656)］. The independent risk factors affecting adverse neonatal outcomes were GDM and IGF-1R. There was a negative correlation between GLP-1 and IGF-1R(r=-0.478, P＜0.05). 
ConclusionSerum GLP-1 in patients with gestational diabetes negatively affects adverse neonatal outcomes, while IGF-1R in placental tissues positively affects adverse neonatal outcomes, which warrants attention in clinical practice.


Key words: diabetes, gestational, glucagon, placenta

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