妊娠期糖尿病患者氧化应激水平变化及临床意义*

目的:研究GDM孕妇与正常孕妇血清MDA、SOD及GSH水平变化,探索它们与GDM之间的相互关系,追踪各组妊娠结局研究其临床意义。方法:选取175例孕妇为研究对象,分为GDM组(93例)和对照组(82例)。采用微量法测定血清丙二醛(MDA)、谷胱甘肽(GSH)及超氧化物歧化酶(SOD)水平,并对妊娠结局进行相关性分析。结果:(1) GDM组年龄、孕前体重、BMI值均高于对照组,GSH和SOD水平均低于对照组,MDA水平高于对照组,差异有统计学意义(P0.05);(2) GDM组MDA水平与孕前体重呈负相关(r=-0.3547,P0.05),SOD水平与新生儿出生体重呈正相关(r=0.3292,P0.05),SOD值与早产之间有密切联系(足月产12.68±0.85 vs.早产8.08±1.18, P 0.05),GSH、SOD水平与孕前体重之间,MDA、GSH水平与新生儿出生体重之间,MDA、GSH水平与早产之间均无明显相关性(P0.05),MDA、GSH和SOD水平与剖宫产及胎膜早破均无明显相关性(P0.05)。结论:GDM存在明显的氧化应激反应,GSH、MDA与SOD可以作为评估GDM氧化应激的有效标志物,其与不良妊娠结局有关。

Changes in Biomarkers of Oxidative Stress and Their Clinical Significance in Gestational Diabetes Mellitus*

ABSTRACT Objective: To investigated changes in malondialdehyde (MDA), glutathione (GSH), or superoxide dismutase (SOD) and their relationship with pregnancy outcomes in patients with GDM to evaluate their clinical significance. Methods: The study included 2 groups of pregnant women (GDM and healthy controls). Oxidative stress biomarkers were evaluated by absorbance-based assay, and all patients'' pregnancy outcomes were tracked. Results: In the GDM group, women were older, had a higher prepregnancy weight, a higher BMI value, delivered at earlier gestational weeks, Women with GDM showed increased levels of MDA and reduced expression levels of GSH and SOD compared with control group. In the GDM group, MDA levels were negatively associated with prepregnancy weight, and SOD levels were positively correlated with neonatal birth weight. We found an intensive relationship between SOD content and preterm birth in the GDM group. Moreover, prepregnancy weight don''t associated with GSH and SOD levels. There is no significant difference between the level of MDA/GSH and neonatal birth weight as well as preterm birth. MDA, GSH, and SOD levels were not associated with an increased risk of cesarean delivery or PROM. Conclusion: This study indicates there is oxidative stress in GDM. and the changes in biomarkers we measured are associated with adverse pregnancy outcomes.