Relationship between AFP,free-βHCG,uE3 and GDM in the second trimester of pregnancy

doi:10.3969/j.issn.1673-8640.2021.08.010

Abstract

Abstract:

Objective To investigate the relationship between serum alpha fetoprotein（AFP）,free beta human chorionic gonadotrophin（free-βHCG）,unconjugated estriol（uE3） and gestational diabetes mellitus（GDM） in the second trimester of pregnancy. Methods A total of 17 005 pregnant women who underwent Down's screening in the second trimester of pregnancy and delivered were enrolled,and they were classified into GDM patients（GDM group,378 cases） and healthy pregnant women（control group,16 627 cases）. Serum AFP,free-βHCG and uE3 were determined by time-resolved fluorescence immunoassay. The multiple of median（MoM） of each index was calculated. Multivariate Logistic regression analysis was used to analyze the influencing factors of GDM,and receptor operating characteristic（ROC） curve was drawn to evaluate the diagnostic values of AFP MoM,free-βHCG MoM and uE3 MoM for GDM. Results The age,body mass index（BMI）,fasting blood glucose（FBG）,postprandial 1 h blood glucose,postprandial 2 h blood glucose,AFP MoM,free-βHCG MoM in GDM group were higher than those in control group（P<0.05）,and the uE3 MoM was lower than that in control group（P<0.05）. Gestational week,systolic blood pressure,diastolic blood pressure and blood lipid in the 2 groups had no statistical significance （P>0.05）. Age,BMI,FBG,postprandial 1 h blood glucose,postprandial 2 h blood glucose,AFP MoM and free-βHCG MoM were independent risk factors of GDM [odds ratios（OR） were 1.093,1.107,1.359,1.587,1.520,1.254,1.242,95% confidence interval（CI） were 1.021-1.135,1.058-1.249,1.167-1.560,1.224-1.813,1.372-1.796,1.103-1.458,1.076-1.412],and uE3 MoM was an independent protective factor for GDM（OR=0.901,95%CI 0.864-0.956）. The areas under curves（AUC） of AFP MoM,free-βHCG MoM,uE3 MoM and the combined determination for diagnosing GDM were 0.904,0.852,0.854 and 0.931,respectively. Conclusions AFP,free-βHCG and uE3 play roles in the diagnosis of GDM,which can predict GDM.

Key words: Alpha fetoprotein, Free beta human chorionic gonadotrophin, Unconjugated estriol, Gestational diabetes mellitus

CLC Number:

R446.1

WANG Yu, ZHANG Wenwen, LIU Meiling, LIU Xiaojuan. Relationship between AFP,free-βHCG,uE3 and GDM in the second trimester of pregnancy[J]. Laboratory Medicine, 2021, 36(8): 828-832.

Figures/Tables 3

References 21

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组别	例数	年龄/岁	BMI/ （kg/m²）	孕周/周	收缩压/kPa	舒张压/kPa	FBG/（mmol/L）	餐后1 h血糖/（mmol/L）
GDM组	378	29.61±5.90	22.36±1.45	17.02±1.09	15.16±1.38	9.87±1.15	4.97±0.55	7.83±1.78
正常妊娠组	16 627	28.35±5.42	21.97±1.53	16.96±1.16	15.72±1.22	9.50±1.27	4.62±0.59	7.29±1.86
t值		4.469	4.913	1.002	0.886	1.642	11.425	5.591
P值		0.000	0.000	0.319	0.379	0.100	0.000	0.000
组别	餐后2 h血糖/（mmol/L）	TC/ （mmol/L）	TG/ （mmol/L）	HDL-C/（mmol/L）	LDL-C/（mmol/L）	AFP MoM	free-βHCG MoM	uE3 MoM
GDM组	6.75±1.33	5.46±1.09	2.53±0.86	2.02±1.05	2.98±0.87	1.79±0.41	1.82±0.30	0.65±0.07
正常妊娠组	6.08±1.28	5.38±1.02	2.49±0.90	2.07±1.00	3.03±0.93	1.13±0.38	1.09±0.24	0.94±0.08
t值	10.057	1.512	0.869	-0.964	-1.045	33.336	58.114	-69.872
P值	0.000	0.132	0.392	0.337	0.301	0.000	0.000	0.000

组别	例数	年龄/岁	BMI/ （kg/m²）	孕周/周	收缩压/kPa	舒张压/kPa	FBG/（mmol/L）	餐后1 h血糖/（mmol/L）
GDM组	378	29.61±5.90	22.36±1.45	17.02±1.09	15.16±1.38	9.87±1.15	4.97±0.55	7.83±1.78
正常妊娠组	16 627	28.35±5.42	21.97±1.53	16.96±1.16	15.72±1.22	9.50±1.27	4.62±0.59	7.29±1.86
t值		4.469	4.913	1.002	0.886	1.642	11.425	5.591
P值		0.000	0.000	0.319	0.379	0.100	0.000	0.000
组别	餐后2 h血糖/（mmol/L）	TC/ （mmol/L）	TG/ （mmol/L）	HDL-C/（mmol/L）	LDL-C/（mmol/L）	AFP MoM	free-βHCG MoM	uE3 MoM
GDM组	6.75±1.33	5.46±1.09	2.53±0.86	2.02±1.05	2.98±0.87	1.79±0.41	1.82±0.30	0.65±0.07
正常妊娠组	6.08±1.28	5.38±1.02	2.49±0.90	2.07±1.00	3.03±0.93	1.13±0.38	1.09±0.24	0.94±0.08
t值	10.057	1.512	0.869	-0.964	-1.045	33.336	58.114	-69.872
P值	0.000	0.132	0.392	0.337	0.301	0.000	0.000	0.000

项目	OR值（95%CI）	回归系数	标准误	Wald χ²值	P值
年龄	1.093（1.021~1.135）	0.089	0.016	3.735	0.044
BMI	1.107（1.058~1.249）	0.102	0.015	4.102	0.041
FBG	1.359（1.167~1.560）	0.307	0.073	3.938	0.046
餐后1 h血糖	1.587（1.224~1.813）	0.462	0.026	4.164	0.037
餐后2 h血糖	1.520（1.372~1.796）	0.419	0.101	4.578	0.032
AFP MoM	1.254（1.103~1.458）	0.226	0.032	6.829	0.009
free-βHCG MoM	1.242（1.076~1.412）	0.217	0.024	5.732	0.014
uE3 MoM	0.901（0.864~0.956）	-0.104	0.019	5.136	0.022

项目	OR值（95%CI）	回归系数	标准误	Wald χ²值	P值
年龄	1.093（1.021~1.135）	0.089	0.016	3.735	0.044
BMI	1.107（1.058~1.249）	0.102	0.015	4.102	0.041
FBG	1.359（1.167~1.560）	0.307	0.073	3.938	0.046
餐后1 h血糖	1.587（1.224~1.813）	0.462	0.026	4.164	0.037
餐后2 h血糖	1.520（1.372~1.796）	0.419	0.101	4.578	0.032
AFP MoM	1.254（1.103~1.458）	0.226	0.032	6.829	0.009
free-βHCG MoM	1.242（1.076~1.412）	0.217	0.024	5.732	0.014
uE3 MoM	0.901（0.864~0.956）	-0.104	0.019	5.136	0.022