| 摘要: |
| 目的 探讨浙江大学(ZJU)指数、泛免疫炎症值(PIV)与妊娠期糖尿病(GDM)孕妇胰岛素抵抗(IR)和围产结局的关系。方法 收集2023年1月—2025年2月于我院治疗的GDM孕妇188例(GDM组)的资料,另按照1:1比例收集同期口服葡萄糖耐量试验确定为正常糖耐量的孕妇188例(对照组)的资料,计算ZJU指数、PIV和稳态模型(HOMA)-IR。Spearman相关分析GDM孕妇ZJU指数、PIV与HOMA-IR的相关性。根据围产结局将GDM 孕妇分为不良组和良好组,分析GDM孕妇围产结局的因素及ZJU指数、PIV的预测效能。结果 与对照组比较,GDM组ZJU指数、PIV和HOMA-IR升高(P＜0.05)。GDM孕妇ZJU指数、PIV与HOMA-IR呈正相关(rs＝0.694、0.617,P均＜0.001)。多因素Logistic回归分析发现年龄增加(OR＝1.494,95%CI：1.207～1.848,P＜0.001)、HOMA-IR升高(OR＝1.309,95%CI：1.130～1.516,P＜0.001)、ZJU指数升高(OR＝1.496,95%CI：1.280～1.747,P＜0.001)、PIV升高(OR＝1.016,95%CI：1.009～1.024,P＜0.001)为GDM孕妇围产结局不良的独立危险因素。ZJU指数、PIV联合预测GDM孕妇围产结局不良的ROC曲线下面积为0.892,优于ZJU指数、PIV单独预测(P＜0.05)。结论 GDM孕妇ZJU指数、PIV升高与IR加重和围产结局不良相关,ZJU指数联合PIV对围产结局有较高的预测效能,可能作为预测GDM孕妇围产结局的新型组合指标。 |
| 关键词: 妊娠期糖尿病 浙江大学指数 泛免疫炎症值 胰岛素抵抗 围产结局 |
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| 基金项目:陕西省科学技术研究发展计划项目（2022SF-729） |
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| Study on the Relationship Between ZJU Index, Pan-Immune Inflammation Value, and Insulin Resistance and Perinatal Outcomes in Pregnant Women with Gestational Diabetes Mellitus |
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1.Yulin Hospital, The First Affiliated Hospital of Xi'2.'3.an Jiaotong University;1.Yulin Hospital, The First Affiliated Hospital of Xi'2.'3.an Jiaotong University
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| Abstract: |
| Objective To investigate the relationship between the Zhejiang university (ZJU) index, pan-immune inflammation value (PIV), and insulin resistance (IR) and perinatal outcomes in pregnant women with gestational diabetes mellitus (GDM). Methods Data from 188 GDM pregnant women (GDM group) admitted to our hospital from January 2023 to February 2025 were collected. Additionally, data from 188 pregnant women with normal glucose tolerance confirmed by oral glucose tolerance test during the same period were collected as controls in a 1:1 ratio. The ZJU index, PIV, and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Spearman correlation analysis was used to assess the relationships between ZJU index, PIV, and HOMA-IR in the GDM group. The GDM patients were further divided into adverse and favorable outcome groups based on their perinatal outcomes. Factors influencing perinatal outcomes and the predictive efficacy of ZJU index and PIV were analyzed. Results Compared with the control group, the GDM group showed significantly higher ZJU index, PIV, and HOMA-IR levels (P<0.05). The ZJU index and PIV were positively correlated with HOMA-IR in GDM patients (rs= 0.694 and 0.617, all P＜0.001). The incidence of adverse perinatal outcomes in the GDM group was 38.30% (72/188). SMultivariate Logistic regression analysis identified increased age (OR = 1.494, 95%CI: 1.207 to 1.848, P < 0.001), elevated HOMA-IR (OR＝1.309,95%CI：1.130～1.516,P＜0.001), increased ZJU index (OR = 1.496, 95%CI: 1.280 to 1.747, P < 0.001), and elevated PIV (OR = 1.016, 95%CI: 1.009 to 1.024, P < 0.001) were independent risk factors for adverse perinatal outcomes in GDM patients. The areas under the ROC curve of the ZJU index, PIV, and their combination for predicting adverse perinatal outcomes were 0.806, 0.799, and 0.892, respectively. The corresponding sensitivities were 72.22%, 98.61%, and 80.56%, and specificities were 73.28%, 48.28%, and 80.17%. The combined prediction model showed better performance than either marker alone (P < 0.05). Conclusion Elevated ZJU index and PIV levels in GDM patients are associated with increased insulin resistance and adverse perinatal outcomes. The combination of ZJU index and PIV demonstrates high predictive value for perinatal outcomes in GDM patients. |
| Key words: Gestational diabetes mellitus Zhejiang university index Pan-immune inflammation value Insulin resistance Perinatal outcomes |
