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妊娠期糖尿病患者血清分泌性卷曲相关蛋白-5、热休克蛋白60、溶质载体家族16成员11的表达及其与胰岛素抵抗的关系

Expression levels of serum secreted frizzled-related protein 5, heat shock protein 60 and solute carrier family 16 member 11 in patients with gestational diabetes mellitus and their relationships with insulin resistance

    摘要
  • 摘要:
    目的 探讨分泌性卷曲相关蛋白-5(sFRP5)、热休克蛋白60(HSP60)、溶质载体家族16成员11(SLC16A11)在妊娠期糖尿病(GDM)患者血清中的表达及其与胰岛素抵抗的关系。
    方法 选取2022年1月—2023年12月在本院就诊的120例GDM患者为研究组，另选取同期120例健康孕妇为对照组。检测血清sFRP5、HSP60、SLC16A11表达水平; 检测并计算胰岛素抵抗相关指标空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)的水平; 采用Pearson法分析血清sFRP5、HSP60、SLC16A11与胰岛素抵抗的相关性; 采用Logistic回归分析法与受试者工作特征(ROC)曲线分析血清sFRP5、HSP60、SLC16A11与GDM的相关性。
    结果 研究组血清sFRP5表达低于对照组，血清HSP60、SLC16A11、FBG、FINS、HOMA-IR高于对照组，差异有统计学意义(P < 0.05)。Pearson相关性分析显示，血清sFRP5与HSP60、SLC16A11、FBG、FINS、HOMA-IR呈负相关(P < 0.05); 血清HSP60与SLC16A11、FBG、FINS、HOMA-IR呈正相关(P < 0.05); 血清SLC16A11与FBG、FINS、HOMA-IR呈正相关(P < 0.05)。多因素Logistic回归分析显示, HSP60、SLC16A11、FBG、FINS、HOMA-IR是妊娠期患者发生GDM的影响因素，sFRP5是保护因素(P < 0.05)。血清sFRP5、HSP60、SLC16A11联合诊断妊娠期患者发生GDM的曲线下面积(AUC)为0.924, 3项指标联合诊断价值优于各指标单独诊断(P均 < 0.05)。
    结论 GDM患者血清sFRP5水平降低，HSP60、SLC16A11水平升高; 3项指标均为妊娠期患者发生GDM的影响因素，且与胰岛素抵抗相关; 3项指标联合对GDM具有较高的诊断效能。

     

    Abstract:
    Objective To investigate the expression levels of secreted frizzled-related protein 5 (sFRP5), heat shock protein 60 (HSP60) and solute carrier family 16 member 11 (SLC16A11) in serum of patients with gestational diabetes mellitus (GDM) and their relationships with insulin resistance.
    Methods A total of 120 GDM patients in the hospital from January 2022 to December 2023 were selected as study group, and another 120 healthy pregnant women in the same period were selected as control group. The expression levels of serum sFRP5, HSP60 and SLC16A11 were detected; the levels of insulin resistance-related indicatorsfasting blood glucose (FBG), fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR)were measured and calculated; the Pearson's correlation method was used to analyze the correlations of serum sFRP5, HSP60 and SLC16A11 with insulin resistance; the Logistic regression andysis and receiver operating characteristic (ROC) curve analysis were used to assess the relationships of serum sFRP5, HSP60 and SLC16A11 with GDM.
    Results The serum sFRP5 expression in the study group was significantly lower than that in the control group, while the serum HSP60, SLC16A11, FBG, FINS and HOMA-IR levels were significantly higher than those in the control group (P < 0.05). Pearson's correlation analysis showed that serum sFRP5 was negatively correlated with HSP60, SLC16A11, FBG, FINS and HOMA-IR (P < 0.05); serum HSP60 was positively correlated with SLC16A11, FBG, FINS and HOMA-IR (P < 0.05); serum SLC16A11 was positively correlated with FBG, FINS and HOMA-IR (P < 0.05). Multivariate Logistic regression analysis revealed that HSP60, SLC16A11, FBG, FINS and HOMA-IR were risk factors for GDM in pregnant patients, while sFRP5 was a protective factor (P < 0.05). The area under the curve (AUC) for the combined diagnosis of GDM in pregnant patients by serum sFRP5, HSP60 and SLC16A11 was 0.924, indicating that the combined diagnostic value of three indicators was superior to that of each individual indicator (all P < 0.05).
    Conclusion GDM patients exhibit decreased serum sFRP5 level and increased HSP60 and SLC16A11 levels; three indicators are factors influencing the occurrence of GDM in pregnant patients, and are associated with insulin resistance; the combination of three indicators exhibits high diagnostic efficacy for GDM.

     

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