摘要
目的探讨血清外泌体长链非编码RNA X染色体失活特异转录物(LncRNA XIST)、微小RNA(miR)-130a-3p在妊娠期糖尿病(GDM)患者中的表达及与妊娠结局的关系。方法选取2021年1月至2024年1月该院收治的149例GDM患者(GDM组)和149例产检健康的孕妇(对照组),检测并比较两组血清外泌体LncRNA XIST、miR-130a-3p及糖脂代谢指标,采用Pearson法分析LncRNA XIST、miR-130a-3p水平与糖脂代谢指标的相关性。采用单因素和多因素Logistic回归模型分析GDM患者妊娠结局的影响因素。采用受试者工作特征(ROC)曲线分析血清外泌体LncRNA XIST、miR-130a-3p水平单独及联合检测对GDM患者妊娠结局的预测效能。结果GDM组血清外泌体LncRNA XIST、空腹胰岛素(FINS)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、餐后2 h血葡萄糖(2 hPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于对照组(P<0.05),miR-130a-3p、高密度脂蛋白胆固醇(HDL-C)水平低于对照组(P<0.05)。LncRNA XIST与FINS、FBG、HOMA-IR、2 hPG、TC、TG、LDL-C呈正相关(P<0.05),与HDL-C呈负相关(P<0.05);miR-130a-3p与FINS、FBG、HOMA-IR、2 hPG、TC、TG、LDL-C呈负相关(P<0.05),与HDL-C呈正相关(P<0.05)。149例GDM患者出现不良妊娠结局43例,占比28.86%,FBG水平升高、LncRNA XIST水平升高、HOMA-IR升高是GDM患者不良妊娠结局的危险因素(P<0.05),miR-130a-3p水平升高则是保护因素(P<0.05)。ROC曲线分析结果显示,联合检测的预测效能优于单项指标检测的预测效能。结论GDM患者血清外泌体LncRNA XIST呈高表达,miR-130a-3p呈低表达,且联合检测上述指标对妊娠结局具有较高的预测价值。
Objective To investigate the expression of serum exosomal long non-coding RNA X chromosome inactivation specific transcript(LncRNA XIST)and microRNA(miR)-130a-3p in gestational diabetes mellitus(GDM)patients and its relationship with pregnancy outcome.Methods A total of 149 GDM patients(GDM group)and 149 healthy pregnant women(control group)admitted to the hospital from January 2021 to January 2024 were selected.Serum exosomal LncRNA XIST,miR-130a-3p and glucose and lipid metabolism indexes of the two groups were detected and compared.The correlation of LncRNA XIST and miR-130a-3p levels with glycolipid metabolism indexes was analyzed by Pearson method.Univariate and multivariate Logistic regression models were used to analyze the influencing factors of pregnancy outcomes in GDM patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum exosomal LncRNA XIST and miR-130a-3p levels alone and in combination for pregnancy outcomes in GDM patients.Results Serum exosomal LncRNA XIST levels,fasting insulin(FINS),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),2-hour postprandial glucose(2 hPG),total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)levels in GDM group were higher than those in control group(P<0.05),and the levels of miR-130a-3p and high density lipoprotein cholesterol(HDL-C)were lower than those in the control group(P<0.05).LncRNA XIST was positively correlated with FINS,FBG,HOMA-IR,2 hPG,TC,TG and LDL-C,and negatively correlated with HDL-C(P<0.05).miR-130a-3p was negatively correlated with FINS,FBG,HOMA-IR,2 hPG,TC,TG and LDL-C,and positively correlated with HDL-C(P<0.05).Among the 149 GDM patients,43 cases showed adverse pregnancy outcome,accounting for 28.86%.The increase level of FBG,the increase level of LncRNA XIST and the increase of HOMA-IR were risk factors for adverse pregnancy outcome in GDM patients,while the increase of miR-130a-3p was a protective factor.The ROC curve analysis showed that the predictive efficacy of combined detection was superior to that of single indicator detection.Conclusion The serum exosomal LncRNA XIST of GDM patients is highly expressed,and miR-130a-3p is lowly expressed,and the combined detection of the above indexes has a high predictive value for pregnancy outcome.
作者
赵瑜
方美凤
袁虎
贾颖娜
宋珍源
ZHAO Yu;FANG Meifeng;YUAN Hu;JIA Yingna;SONG Zhenyuan(Department of Endocrine,the Affiliated Suzhou Hospital of Nanjing Medical University•Suzhou Municipal Hospital,Suzhou,Jiangsu 215001,China;Department of Gynaecology and Obstetrics,the Affiliated Suzhou Hospital of Nanjing Medical University•Suzhou Municipal Hospital,Suzhou,Jiangsu 215001,China)
出处
《国际检验医学杂志》
2025年第18期2177-2182,共6页
International Journal of Laboratory Medicine
基金
江苏省妇幼保健科研项目(F202203)。
