在双胞胎怀孕中,第一季度血清费里与妊娠糖尿病之间的单子特异性关联:一项回顾性队列研究
Yanyan Ni1, Yan Bi1, Xiaona Xu1
1School of Medicine, Shanghai Jiao Tong University, International Peace Maternity and Child Health Hospital, Shanghai, China.
Frontiers in endocrinology
|November 10, 2025
概括
怀孕早期血清费里丁 (SF) 的升高与单胆双子 (MCDA) 双胞胎的妊娠期糖尿病 (GDM) 风险有关. 在MCDA怀孕中,SF可以作为早期GDM生物标志物,但在二二 (DCDA) 双胞胎中并非如此.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 内分泌学 在内分泌学.
背景情况:
- 之前的研究将早期怀孕的血清费里 (SF) 与妊娠期糖尿病 (GDM) 的风险联系起来,主要是在单子怀孕中.
- 关于双胞胎怀孕中SF和GDM的证据有限,特别是考虑到胆管性.
- 这项研究调查了双胞胎怀孕中早期的SF水平与GDM风险之间的关联,根据胆管分化进行区分.
研究的目的:
- 检查第一季度血清费里 (SF) 水平与双胞胎怀孕中患妊娠糖尿病 (GDM) 的风险之间的关系.
- 为了确定这种关联是否在双胞胎怀孕的二二 (DCDA) 和单二 (MCDA) 之间有所不同.
主要方法:
- 在2019-2021年期间,对882例双胞胎怀孕 (700例DCDA,182例MCDA) 的回顾性队列研究.
- 排除标准包括早产 (<28周),先前存在的糖尿病和特定的单三 (MCTA) 病例.
- 怀孕期糖尿病 (GDM) 通过75g口服葡萄糖耐受性测试 (OGTT) 诊断;SF测量在头三个月. 使用了后勤回归,相关性和ROC分析.
主要成果:
- 在MCDA怀孕中,与没有GDM (101.68±59.72μg/L) 的女性相比,GDM (101.68±59.72μg/L) 的女性的平均SF水平较高 (79.87±53.11μg/L;p<0.05).
- 在DCDA怀孕中没有发现显著的SF-GDM关联.
- 在MCDA双胞胎中,SF>71.4μg/L独立预测增加了GDM风险 (aOR=2.775;p=0.018),具有显著的趋势 (p=0.012). SF与禁食和1小时OGTT葡萄糖水平正相关.
结论:
- 妊娠早期的高发性SF是双胞胎怀孕中GDM的独立风险因素.
- 血清费里丁 (SF) 可能作为一个预测生物标志物GDM在MCDA双胞胎.
- 对于GDM,SF的预测值因表性不同,在二性双胞胎 (DCDA) 双胞胎中没有观察到显著的关联.
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