Relationship between prolyl 4-hydroxylase subunit alpha 2 level in peripheral blood and adverse pregnancy outcome in patients with gestational diabetes mellitus
10.3760/cma.j.cn115455-20240809-00691
- VernacularTitle:外周血脯氨酰4-羟化酶α2亚基水平与妊娠期糖尿病患者不良妊娠结局的关系
- Author:
Jiangzhong ZENG
1
;
Leilei MAO
1
;
Mengmeng LIN
1
Author Information
1. 温州市中心医院妇产科,温州 325000
- Publication Type:Journal Article
- Keywords:
Diabetes, gestational;
Pregnancy outcome;
Prolyl 4-hydroxylase subunit alpha 2;
Predictive value
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(4):311-317
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the level of prolyl 4-hydroxylase subunit alpha 2 (P4HA2) in peripheral blood and the adverse pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:A retrospective collection of baseline data was conducted on 120 GDM patients who underwent regular prenatal check ups and deliveries in Wenzhou Central Hospital from March 2022 to March 2024, serving as the GDM group. Baseline data from 120 pregnant women with normal glucose tolerance (NGT) during the same period were collected as the NGT group. Baseline data of blood lipids, blood glucose, and peripheral blood P4HA2 between the two groups were compared, and Pearson correlation test was used to determine the correlation between P4HA2 and some clinical indicators. Statistical analysis was conducted on the pregnancy outcomes of GDM patients, divided into the adverse pregnancy group (32 cases) and the normal pregnancy group(88 cases). Baseline data on blood lipids, blood glucose, and peripheral blood P4HA2 were compared between the two groups. Univariate and multivariate Logistic regression analysis were used to screen for factors affecting adverse pregnancy outcomes in GDM patients. Receiver operating characteristic (ROC) curves were also plotted to analyze the predictive value of peripheral blood P4HA2 for adverse pregnancy outcomes in GDM patients.Results:Compared with the NGT group, the GDM group had higher levels of fasting glucose, 2-h glucose, 1-h glucose, glycosylated hemoglobin (HbA 1c), peripheral blood P4HA2, insulin resistance index, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC): (6.26 ± 0.24) mmol/L vs. (4.33 ± 0.15) mmol/L, (9.69 ± 0.18) mmol/L vs. (7.41 ± 0.19) mmol/L, (11.01 ± 0.29) mmol/L vs. (7.10 ± 0.27) mmol/L, (8.54 ± 0.43)% vs. (5.05 ± 0.61)%, (39.03 ± 3.33) μg/L vs. (35.55 ± 3.05) μg/L, 2.50 ± 0.34 vs. 1.95 ± 0.33, (2.56 ± 0.49) mmol/L vs. (2.08 ± 0.37) mmol/L, (3.85 ± 0.25) mmol/L vs. (3.26 ± 0.30) mmol/L, (6.92 ± 0.43) mmol/L vs. (6.25 ± 0.43) mmol/L, and significantly lower levels of high-density lipoprotein cholesterol (HDL)-C: (1.70 ± 0.11) mmol/L vs. (1.87 ± 0.22) mmol/L, there were statistical differences ( P<0.05). Pearson correlation analysis showed that peripheral blood P4HA2 was positively correlated with fasting blood glucose, 2-h blood glucose, 1-h blood glucose, HbA 1c, insulin resistance index, TG, LDL-C, and TC ( r>0, P<0.05); peripheral blood P4HA2 was negatively correlated with HDL-C ( r<0, P<0.05). The fasting blood glucose, 2-h blood glucose, 1-h blood glucose, insulin resistance index, peripheral blood P4HA2, and TC in the adverse pregnancy group were significantly higher than those in the normal pregnancy group:(6.35 ± 0.22) mmol/L vs. (6.23 ± 0.24) mmol/L, (9.78 ± 0.25) mmol/L vs. (9.66 ± 0.14) mmol/L, (11.12 ± 0.33) mmol/L vs. (10.97 ± 0.26) mmol/L, 2.61 ± 0.22 vs. 2.36 ± 0.37, (41.20 ± 3.62) μg/L vs. (38.24 ± 2.85) μg/L, (7.12 ± 0.55) mmol/L vs. (6.84 ± 0.35) mmol/L, there were statistical differences ( P<0.05). Logistic regression analysis showed that fasting blood glucose, 1-h blood glucose, 2-h blood glucose, TC, insulin resistance index, and peripheral blood P4HA2 were related factors affecting pregnancy outcomes in GDM patients ( P<0.05). The ROC curve showed that peripheral blood P4HA2 had good predictive value for adverse pregnancy outcomes in GDM patients, with an area under the curve of 0.729. Conclusions:The high expression of P4HA2 in peripheral blood of GDM patients is closely related to adverse pregnancy, which can provide some reference for clinical prediction of pregnancy outcomes in patients.