Angiopoietin-like protein 8 in early pregnancy improves the prediction of gestational diabetes
Angiopoietin-like protein 8 in early pregnancy improves the prediction of gestational diabetes
复制标题
妊娠早期血管生成素样蛋白 8 可以提高妊娠糖尿病的预测。
DOI：
10.1007/s00125-017-4505-y
复制
发表时间：
2018-03-01
期刊：
影响因子：
8.2
通讯作者：
Hu, Ji
中科院分区：
文献类型：
--
作者：
Huang, Yun;Chen, Xin;Hu, Ji
目的/假设筛查妊娠期糖尿病（GDM）的高危人群在怀孕早期传统上依赖于确定的母体危险因素，然而，这些因素的敏感性和特异性并不令人满意。本研究的目的是确定是否血管生成素样蛋白8（ANGPTL 8）的浓度，无论是单独或与其他危险因素在早期妊娠，可以用来预测随后的GDM.Methods从2015年8月至2016年1月，474名妇女接受产前护理在大约12-16周的妊娠被招募到研究。ANGPTL 8水平在第一次产前访视时测量。所有参与者在妊娠24-28周期间接受75 g OGTT.Results妊娠早期发生GDM的妇女的ANGPTL 8水平显著高于维持正常葡萄糖耐量的妇女（分别为2822 +/- 938 vs 2120 +/- 1118 pg/ml; p < 0.0001）。多变量logistic回归分析显示ANGPTL 8水平与GDM风险显著相关，独立于传统风险因素。此外，ANGPTL 8浓度最高四分位数的女性发生GDM的风险是最低四分位数女性的8.75倍（OR 8.75，95% CI 2.43，31.58）。更重要的是，将ANGPTL 8纳入常规预测模型中显著增加了预测GDM的AUC（0.772vs 0.725; p = 0.019）。结论我们的研究表明，早孕ANGPTL 8水平与妊娠24-28周GDM的风险显著且独立相关。因此，将ANGPTL 8水平与常规危险因素相结合可以提高GDM的预测。
Aims/hypothesis Screening high-risk individuals for gestational diabetes mellitus (GDM) in early pregnancy conventionally relies on established maternal risk factors; however, the sensitivity and specificity of these factors are not satisfactory. The present study aimed to determine whether the concentration of angiopoietin-like protein 8 (ANGPTL8), either alone or combined with other risk factors in early pregnancy, could be used to predict subsequent GDM.Methods From August 2015 to January 2016, 474 women receiving prenatal care at around 12-16 weeks of gestation were recruited into the study. ANGPTL8 levels were measured at the first prenatal visit. All the participants received a 75 g OGTT during weeks 24-28 of gestation.Results ANGPTL8 levels in early pregnancy were considerably higher in women who developed GDM than those who maintained normal glucose tolerance (2822 +/- 938 vs 2120 +/- 1118 pg/ml, respectively; p < 0.0001). Multivariable logistic regression revealed that ANGPTL8 levels were significantly associated with risk of GDM independent of conventional risk factors. In addition, women in the highest quartile of ANGPTL8 concentration had an 8.75-fold higher risk of developing GDM compared with women in the lowest quartile (OR8.75, 95% CI 2.43, 31.58). More importantly, incorporating ANGPTL8 into the conventional prediction model significantly increased the AUC for prediction of GDM (0.772vs 0.725; p = 0.019).Conclusions Our study suggests that ANGPTL8 levels in early pregnancy are significantly and independently associated with risk of GDM at 24-28 weeks of gestation. Combining ANGPTL8 levels with conventional risk factors could thus improve the prediction of GDM.