妊娠期肝内胆汁淤积症患者血清、脐静脉血鸢尾素水平变化及相关性研究
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摘要
目的:探究血清、脐静脉血鸢尾素水平与妊娠期肝内胆汁淤积症(ICP)相关指标之间的相关性,为ICP的病因、治疗等提供参考。方法:采用横断面对照研究方法分析108例正常孕妇、64例轻度ICP患者、39例重度ICP患者的鸢尾素水平,肝、肾功能及脂代谢等指标。结果:脐静脉血鸢尾素浓度均显著低于外周血(P<0.05);正常孕妇血清鸢尾素分别显著低于轻度和重度ICP孕妇(P<0.05);重度ICP孕妇脐静脉血鸢尾素浓度分别显著高于正常孕妇和轻度ICP孕妇(P<0.05)。鸢尾素在最佳界值989.168pg/ml可预测ICP(AUC=0.622,95%CI为0.543～0.701,P<0.05),其敏感度为60.9%,特异度为40.1%。结论:鸢尾素可能在ICP的病理生理过程中起到一定作用;血清鸢尾素对于ICP的诊断有一定参考意义,可能成为ICP诊断、分度的一种新的辅助因子。
Objective:To explore the correlation between serum,umbilical vein irisin and indexes of ICP,and in order to provide a new perspective on the etiology and treatment of ICP.Methods:In this controlled cross-sectional study,the indexes of irisin,liver function,kidney function and lipid metabolism in 108 healthy women with normal pregnancies,64 consecutive pregnant women with mild ICP and 39 with severe ICP were examined.Results:The concentration of irisin in umbilical vein was significantly lower than that in peripheral blood(P<0.05).The serum irisin level of normal pregnant women was significantly lower than that of mild ICP women and severe ICP pregnant women(P<0.05).The levels of iris in umbilical vein of severe ICP pregnant women were significantly higher than those of normal women and mild ICP pregnant women,respectively(P<0.05).At the best cutoff level of 989.168 pg/ml,irisin accurately predicted ICP(AUC=0.622,95%CI=0.543～0.701,P<0.05) with sensitivity and specificity rates of 60.9% and 40.1%,respectively.Conclusion:Irisin may play a role in the pathophysiological process of ICP.The concentration of serum irisin has certain reference significance for the diagnosis of ICP and severe ICP,may become a new auxiliary factor in the diagnosis and grading of ICP.
Objective:To explore the correlation between serum,umbilical vein irisin and indexes of ICP,and in order to provide a new perspective on the etiology and treatment of ICP.Methods:In this controlled cross-sectional study,the indexes of irisin,liver function,kidney function and lipid metabolism in 108 healthy women with normal pregnancies,64 consecutive pregnant women with mild ICP and 39 with severe ICP were examined.Results:The concentration of irisin in umbilical vein was significantly lower than that in peripheral blood(P<0.05).The serum irisin level of normal pregnant women was significantly lower than that of mild ICP women and severe ICP pregnant women(P<0.05).The levels of iris in umbilical vein of severe ICP pregnant women were significantly higher than those of normal women and mild ICP pregnant women,respectively(P<0.05).At the best cutoff level of 989.168 pg/ml,irisin accurately predicted ICP(AUC=0.622,95%CI=0.543～0.701,P<0.05) with sensitivity and specificity rates of 60.9% and 40.1%,respectively.Conclusion:Irisin may play a role in the pathophysiological process of ICP.The concentration of serum irisin has certain reference significance for the diagnosis of ICP and severe ICP,may become a new auxiliary factor in the diagnosis and grading of ICP.
引文
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[2] Usluogullari B,Usluogullari CA,Balkan F,et al.Role of serum levels of irisin and oxidative stress markers in pregnant women with and without gestational diabetes[J].Gynecol Endocrinol,2017,33(5):405-407
[3] 贺晶,杨慧霞,段涛,等.妊娠期肝内胆汁淤积症诊疗指南(2015)[J].临床肝胆病杂志,2015,31(10):1575-1578
[4] Huh JY,Panagiotou G,Mougios V,et al.FNDC5 and irisin in humans:I.Predictors of circulating concentrations in serum and plasma and II.mRNA expression and circulating concentrations in response to weight loss and exercise[J].Metab,2012,61(12):1725-1738
[5] Xiong XQ,Chen D,Sun HJ,et al.FNDC5 overexpression and irisin ameliorate glucose/lipid metabolic derangements and enhance lipolysis in obesity[J].Biochim Biophys Acta,2015,9(1852):1867-1875
[6] Tang H,Yu R,Liu S,et al.Irisin inhibits hepatic cholesterol synthesis via AMPK-SREBP2 signaling[J].EBioMed,2016(6):139-148
[7] 王景莲.妊娠期肝内胆汁淤积症患者血脂及雌激素水平变化情况分析[J].河南医学研究,2016,25(8):1424-1425
[8] 文春蓉,刘敏利.妊娠期肝内胆汁淤积症血脂变化及其临床意义[J].现代医药卫生,2015,31(11):1617-1618
[9] Geenes V,Chappell LC,Seed PT,et al.Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes:a prospective population-based case-control study[J].Hepatol,2014,59(4):1482-1491
[10] Gao S,Li F,Li H,et al.Effects and Molecular Mechanism of GST-Irisin on lipolysis and autocrine function in 3T3-L1 adipocytes[J].PLos ONE,2016,11(1):e147480
[11] Huh JY,Dincer F,Mesfum E,et al.Irisin stimulates muscle growth-related genes and regulates adipocyte differentiation and metabolism in humans[J].Int J Obes (Lond),2014,38(12):1538-1544