Relationship between serum Spexin,FoxO1 and insulin resistance as well as prognosis in patients with gestational diabetes mellitus
- VernacularTitle:妊娠期糖尿病患者血清Spexin、FoxO1水平与胰岛素抵抗及预后的关系
- Author:
Jingjing YANG
1
;
Kanglu YAN
1
;
Jie MENG
1
;
Chunli YANG
1
Author Information
- Publication Type:Journal Article
- Keywords: diabetes,gestational; insulin resistance; forkhead box protein O1; pregnancy outcome; Spexin
- From: Tianjin Medical Journal 2025;53(6):610-614
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the correlation of serum levels of Spexin,FoxO1 and insulin resistance(IR)with prognosis in patients with gestational diabetes mellitus(GDM).Methods A total of 198 patients with GDM were prospectively selected as the GDM group,and 195 healthy pregnant women who underwent physical examinations during the same period were selected as the control group.The age at enrollment,gestational age,triglyceride(TG),pre-pregnancy body weight,fasting insulin(FINS),parity,fasting blood glucose(FBG),total cholesterol(TC)and homeostasis model assessment of insulin resistance index(HOMA-IR)of the subjects were collected.The serum levels of Spexin and FoxO1 in subjects were detected by enzyme-linked immunosorbent assay(ELISA).According to the pregnancy outcome,the GDM patients were divided into the adverse pregnancy outcome group(96 cases)and the good pregnancy outcome group(102 cases).The correlations between serum Spexin,FoxO1,and HOMA-IR in GDM patients were analyzed by Pearson's method.Logistic regression was used to analyze risk factors affecting the pregnancy outcome of GDM patients.The predictive value of serum Spexin and FoxO1 levels for the pregnancy outcome of GDM patients was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of FINS,TG,FBG,Spexin,FoxO1 and HOMA-IR were higher in the GDM group than those in the control group(P＜0.01).Pearson correlation analysis showed that serum levels of Spexin and FoxO1 in GDM patients were positively correlated with HOMA-IR,and serum level of Spexin was positively correlated with FoxO1(P＜0.05).The incidences of gestational hypertension,cesarean section,macrosomia,neonatal malformations,low birth weight infants and neonatal asphyxia were higher in the GDM group than those in the control group(P＜0.05).Serum levels of Spexin and FoxO1 and FINS,FBG and HOMA-IR were significantly higher in the adverse pregnancy group than those in the good pregnancy group(P＜0.01).Multivariate Logistic regression analysis showed that the increased Spexin and FoxO1 were the risk factor for adverse pregnancy outcomes in GDM patients(P＜0.01).The ROC curve analysis showed that the area under the curve(AUC)of serum Spexin and FoxO1 levels for predicting pregnancy outcomes in GDM patients was 0.887 and 0.883,respectively,and the AUC of combined prediction was 0.942.Conclusion Serum levels of Spexin and FoxO1 are elevated in GDM patients,and both are related to IR.The combination of the two can assist in judging the pregnancy outcome of GDM patients.
