The relationship between the serum levels of vascular endothelial growth factor, matrix metalloproteinase-9, S100 calcium binding protein with glycolipid metabolism, pregnancy outcome in pregnant women with gestational diabetes
10.3760/cma.j.cn115455-20241108-00984
- VernacularTitle:妊娠期糖尿病孕妇血清血管内皮生长因子、基质金属蛋白酶9、S100钙结合蛋白B水平与糖脂代谢、妊娠结局的关系
- Author:
Lizhen CHEN
1
;
Lihua CHANG
1
;
Fei LI
1
;
Fenxia LI
1
;
Yanli ZHENG
1
;
Rongrong XU
1
Author Information
1. 西安医学院第二附属医院产一科，西安 710038
- Publication Type:Journal Article
- Keywords:
Diabetes, gestational;
Vascular endothelial growth factors;
Matrix metalloproteinase 9;
Calcium-binding proteins;
Pregnancy outcome
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(7):608-614
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the serum levels of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), S100 calcium binding protein B (S100B) with glycolipid metabolism, pregnancy outcome in pregnant women with gestational diabetes.Methods:The clinical data of 153 pregnant women with gestational diabetes (research group) and 153 healthy pregnant women (control group) in the Second Affiliated Hospital of Xi ′an Medical University from January 2020 to October 2023 were retrospectively analyzed. The serum levels of VEGF, MMP-9 and S100B were measured by enzyme linked immunosorbent assay, and the fasting blood glucose, triglyceride, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting insulin and glycated hemoglobin were measured, and the homeostasis model assessment insulin resistance index (HOMA-IR) was calculated. The adverse outcomes of pregnant women with gestational diabetes were recorded. Pearson method was used to analyze the correlation between glycolipid metabolism indexes and VEGF, MMP-9, S100B in pregnant women with gestational diabetes. Multivariate Logistic regression was used to analyze the independent risk factors of adverse pregnancy outcome in pregnant women with gestational diabetes. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of VEGF, MMP-9 and S100B on adverse pregnancy outcome in pregnant women with gestational diabetes. Results:The fasting blood glucose, fasting insulin, glycated hemoglobin, HOMA-IR, triglyceride, total cholesterol, LDL-C, VEGF, MMP-9 and S100B in research group were significantly higher than those in control group: (9.42 ± 0.65) mmol/L vs. (4.13 ± 0.46) mmol/L, (16.58 ± 2.37) mU/L vs. (13.41 ± 2.05) mU/L, (7.28 ± 0.46)% vs. (4.35 ± 0.39)%, 4.83 ± 0.42 vs. 2.71 ± 0.37, (3.41 ± 0.67) mmol/L vs. (2.85 ± 0.63) mmol/L, (5.54 ± 1.56) mmol/L vs. (5.12 ± 1.50) mmol/L, (3.14 ± 0.97) mmol/L vs. (2.86 ± 0.93) mmol/L, (184.02 ± 30.25) ng/L vs. (156.33 ± 26.41) ng/L, (45.78 ± 7.56) μg/L vs. (29.36 ± 5.03) μg/L and (117.51 ± 25.12) ng/L vs. (89.74 ± 22.46) ng/L, the HDL-C was significantly lower than that in control group: (1.34 ± 0.27) mmol/L vs. (1.42 ± 0.30) mmol/L, and there were statistical differences ( P<0.01 or <0.05). Pearson correlation analysis result showed that VEGF, MMP-9, S100B in pregnant women with gestational diabetes were positively correlated with fasting blood glucose, fasting insulin, glycated hemoglobin, HOMA-IR, triglyceride, total cholesterol and LDL-C ( P<0.01), negatively correlated with HDL-C ( P<0.01). Among 153 pregnant women with gestational diabetes, 49 had adverse pregnancy outcome, and 104 had good pregnancy outcome. The VEGF, MMP-9 and S100B in pregnant women with adverse pregnancy outcome were significantly higher than those in pregnant women with good pregnancy outcome: (212.75 ± 28.63) ng/L vs. (170.49 ± 26.58) ng/L, (52.37 ± 7.14) μg/L vs. (42.68 ± 6.35) μg/L and (136.83 ± 23.62) ng/L vs. (108.41 ± 21.35) ng/L, and there were statistical differences ( P<0.01). Multivariate Logistic regression analysis result showed that VEGF, MMP-9 and S100B were independent risk factors for adverse pregnancy outcome in pregnant women with gestational diabetes ( OR = 7.013, 5.382 and 6.129; 95% CI 5.206 to 9.447, 3.449 to 8.398 and 3.520 to 10.673; P<0.01). ROC curve analysis result showed that the area under the curve of VEGF, MMP-9 combined S100B in predicting adverse pregnancy outcome in pregnant women with gestational diabetes was significantly larger than that of VEGF, MMP-9 and S100B alone (0.945 vs. 0.863, 0.847 and 0.801; P<0.05 or <0.01), with sensitivity of 89.80% and specificity of 91.30%. Conclusions:The high serum levels of VEGF, MMP-9 and S100B are associated with abnormal glycolipid metabolism and adverse pregnancy outcome in pregnant women with gestational diabetes, and the combination of the three indexes has a high predictive value for adverse pregnancy outcome.
