Predictive role of serum fibronectin level in the second trimester of pregnancy for patients with gestational diabetes mellitus complicated with preeclampsia

doi:10.3969/j.issn.1673-8640.2020.06.010

Abstract

Abstract:

Objective To investigate the predictive role of serum fibronectin（Fn） level in the second trimester of pregnancy for patients with gestational diabetes mellitus（GDM） complicated with preeclampsia（PE）. Methods A prospective case-control study was conducted to select 458 serum samples from pregnant women with GDM from 24 to 28 weeks of gestational weeks to observe their pregnancy outcomes. Totally,30 patients developed PE as PE-GDM group,10 patients were diagnosed as gestational hypertension（GH） as GH-GDM group,and 40 cases of GDM with full-term normal delivery and no complication were enrolled from 458 subjects（GDM group）. Immunofluorescence assay was used to determine the levels of Fn and related clinical biochemical indicators in the 3 groups. Results The level of Fn in PE-GDM group was 221.72（202.33,264.52）mg/L,those in GH-GDM group and GDM group were 185.13（174.30,216.21）mg/L and 198.77（185.65,208.37）mg/L,respectively（P<0.05）. There was no statistical significance in Fn levels between GH-GDM group and GDM group（P>0.05）. The levels of triglyceride（TG） and pre-pregnancy body mass index（BMI） in PE-GDM group were 3.60（2.96,4.62）mmol/L and （25.10±3.20）kg/m²,respectively,and they were higher than those in GH-GDM group [2.32 （2.00,2.81）mmol/L and （23.97±3.36）kg/m²] and GDM group [2.52 （2.13,2.94）mmol/L and （23.38±3.61）kg/m²]（P<0.05）. Receiver operating characteristic（ROC） curve analysis showed that the areas under curves（AUC） of Fn,TG and pre-pregnancy BMI were 0.778,0.794 and 0.654,respectively,and the 95% confidence intervals（CI） were 0.665-0.890,0.681-0.907 and 0.526-0.782,respectively. The AUC of the combined determination of the 3 indicators was 0.818,and the 95% CI was 0.714-0.921. Conclusions Serum Fn levels in the second trimester have a certain predictive value for GDM patients with PE. The combined determination of Fn,TG and pre-pregnancy BMI in the second trimester of pregnancy is important in predicting GDM with PE.

Key words: Fibronectin, Preeclampsia, Gestational diabetes mellitus, Predictive value

CLC Number:

R446.1

XU Zhen, MA Lijuan, WU Siyi, WANG Yan, JIA Keke. Predictive role of serum fibronectin level in the second trimester of pregnancy for patients with gestational diabetes mellitus complicated with preeclampsia[J]. Laboratory Medicine, 2020, 35(6): 561-565.

Figures/Tables 5

References 16

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组别	年龄/岁	孕次/次	产次/次	孕周/周	孕前BMI/（kg/m²）	孕中BMI/（kg/m²）	收缩压/kPa	舒张压/kPa
PE-GDM组	33.37±5.11	1（1,2）^#	0（0,0）^*	26（25,27）	25.10±3.20^*#	29.20±3.34^*	20.12±1.74^*	12.27±1.30^*
GH-GDM组	36.30±5.21	2（2,3）	0（0,1）	25.5（25,26）	23.97±3.36	30.35±3.06^*	19.86±1.59^*	12.67±1.91^*
GDM组	33.65±4.00	2（1,3）	0（0,1）	26（25,27）	23.38±3.61	25.83±3.66	15.39±1.37	9.69±1.01

组别	年龄/岁	孕次/次	产次/次	孕周/周	孕前BMI/（kg/m²）	孕中BMI/（kg/m²）	收缩压/kPa	舒张压/kPa
PE-GDM组	33.37±5.11	1（1,2）^#	0（0,0）^*	26（25,27）	25.10±3.20^*#	29.20±3.34^*	20.12±1.74^*	12.27±1.30^*
GH-GDM组	36.30±5.21	2（2,3）	0（0,1）	25.5（25,26）	23.97±3.36	30.35±3.06^*	19.86±1.59^*	12.67±1.91^*
GDM组	33.65±4.00	2（1,3）	0（0,1）	26（25,27）	23.38±3.61	25.83±3.66	15.39±1.37	9.69±1.01

组别	Fn/（mg/L）	CRP/（mg/L）		TC/（mmol/L）		TG/（mmol/L）		HDL-C/（mmol/L）
PE-GDM组	221.72（202.33,264.52）^*#	4.28（2.67,7.51）		5.55（4.94,6.14）		3.60（2.96,4.62）^*#		1.58±0.33^*
GH-GDM组	185.13（174.30,216.21）	3.56（2.00,8.71）		5.06（4.60,5.29）^*		2.32（2.00,2.81）		1.51±0.21^*
GDM组	198.77（185.65,208.37）	3.71（1.75,7.57）		6.13（5.26,6.58）		2.52（2.13,2.94）		1.83±0.28
组别	LDL-C/（mmol/L）		空腹血糖/（mmol/L）		OGTT1 h/（mmol/L）		OGTT2 h/（mmol/L）
PE-GDM组	2.88±0.67^*		4.85（4.60,5.00）		10.34±2.06		8.90（7.60,9.40）
GH-GDM组	2.77±0.57^*		4.85（4.70,5.40）		11.17±1.98		9.20（8.20,10.60）
GDM组	3.43±0.82		4.70（4.60,5.20）		10.23±1.31		8.90（8.10,9.40）

组别	Fn/（mg/L）	CRP/（mg/L）		TC/（mmol/L）		TG/（mmol/L）		HDL-C/（mmol/L）
PE-GDM组	221.72（202.33,264.52）^*#	4.28（2.67,7.51）		5.55（4.94,6.14）		3.60（2.96,4.62）^*#		1.58±0.33^*
GH-GDM组	185.13（174.30,216.21）	3.56（2.00,8.71）		5.06（4.60,5.29）^*		2.32（2.00,2.81）		1.51±0.21^*
GDM组	198.77（185.65,208.37）	3.71（1.75,7.57）		6.13（5.26,6.58）		2.52（2.13,2.94）		1.83±0.28
组别	LDL-C/（mmol/L）		空腹血糖/（mmol/L）		OGTT1 h/（mmol/L）		OGTT2 h/（mmol/L）
PE-GDM组	2.88±0.67^*		4.85（4.60,5.00）		10.34±2.06		8.90（7.60,9.40）
GH-GDM组	2.77±0.57^*		4.85（4.70,5.40）		11.17±1.98		9.20（8.20,10.60）
GDM组	3.43±0.82		4.70（4.60,5.20）		10.23±1.31		8.90（8.10,9.40）

项目	AUC	95%CI	P值	临界值
Fn	0.778	0.665~0.890	0.000	210.48 mg/L
TG	0.794	0.681~0.907	0.000	3.35 mmmol/L
孕前BMI	0.654	0.526~0.782	0.029	23.35 kg/m²
3项联合	0.818	0.714~0.921	0.000