血清成纤维细胞生长因子2、21、23与妊娠期糖尿病患者新生儿结局的关系

摘要 目的：探讨血清成纤维细胞生长因子2（FGF2）、成纤维细胞生长因子21（FGF21）、成纤维细胞生长因子23（FGF23）与妊娠期糖尿病（GDM）患者新生儿结局的关系。方法：选取2021年1月～2022年12月期间于我院产检的妊娠24～28周孕妇147例，均进行口服葡萄糖耐量试验（OGTT），根据OGTT结果分为GDM组（n=86）和非GDM组（n=61）。其中GDM组根据新生儿结局分为不良组（n=21）和良好组（n=65）。对比非GDM组、GDM组的血清FGF2、FGF21、FGF23水平及新生儿结局情况。对比不良组和良好组的血清FGF2、FGF21、FGF23水平。单因素及多因素Logistic回归分析影响GDM患者新生儿结局的影响因素。结果：GDM组的血清FGF2、FGF21、FGF23水平均高于非GDM组（P<0.05）。GDM组的不良新生儿结局总发生率高于非GDM组（P<0.05）。不良组的血清FGF2、FGF21、FGF23水平均高于良好组（P<0.05）。单因素分析显示，GDM患者不良新生儿结局与年龄、孕前体质量指数（BMI）、分娩前BMI、空腹血糖（FPG）、餐后2 h血糖（2hPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）有关（P<0.05）。多因素分析结果显示，年龄偏高、FPG偏高、孕前BMI偏高、2hPG偏高、分娩前BMI偏高、HOMA-IR偏高、FGF2偏高、FINS偏高、FGF21偏高、FGF23偏高均是GDM患者不良新生儿结局的危险因素（P<0.05）。结论：GDM患者血清FGF2、FGF21、FGF23水平升高，其与年龄、孕前BMI、分娩前BMI、FPG、2hPG、FINS、HOMA-IR偏高均是导致GDM患者不良新生儿结局的危险因素。

Relationship between Serum Fibroblast Growth Factor 2, 21, 23 and Neonatal Outcome in Patients with Gestational Diabetes

ABSTRACT Objective: To investigate the relationship between serum fibroblast growth factor 2 (FGF2), fibroblast growth factor 21 (FGF21), fibroblast growth factor 23 (FGF23) and neonatal outcome in patients with gestational diabetes mellitus (GDM). Methods: 147 pregnant women at 24 to 28 weeks of gestation who were examined in our hospital from January 2021 to December 2022 were selected, oral glucose tolerance test (OGTT) was conducted for all patients. According to the OGTT results, they were divided into GDM group (n=86) and non-GDM group (n=61). GDM group was divided into poor group (n=21) and good group (n=65) according to neonatal outcome. The serum FGF2, FGF21, FGF23 levels and neonatal outcome in the non-GDM group and the GDM group were compared. Serum FGF2, FGF21 and FGF23 levels in the poor group and the good group were compared. Univariate and multivariate Logistic regression analysis was used to analyze the influencing factors of neonatal outcome in patients with GDM. Results: The serum FGF2, FGF21 and FGF23 levels in the GDM group were higher than those in the non-GDM group (P<0.05). The overall incidence of adverse neonatal outcome in the GDM group was higher than that in the non-GDM group (P<0.05). The serum FGF2, FGF21 and FGF23 levels in the poor group were higher than those in the good group (P<0.05). Univariate analysis showed that adverse neonatal outcome in patients with GDM were related to age, pre-pregnancy body mass index (BMI), pre-delivery BMI, fasting plasma glucose (FPG), 2h post-meal blood glucose (2hPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) (P<0.05). The results of multivariate analysis showed that higher age, higher FPG, higher pre-pregnancy BMI, higher 2hPG, higher pre-delivery BMI, higher HOMA-IR, higher FGF2, higher FINS, higher FGF21 and higher FGF23 were all risk factors for poor neonatal outcome in patients with GDM (P<0.05). Conclusion: The serum FGF2, FGF21 and FGF23 levels in patients with GDM are elevated, which together with higher age, pre-pregnancy BMI, pre-delivery BMI, FPG, 2hPG, FINS and HOMA-IR are risk factors for adverse neonatal outcome in patients with GDM.