Relationship between serum levels of fructosamine and proprotein convertase subtilisin/kexin type 9 and thyroid function and pregnancy outcomes in pregnant women with subclinical hypothyroidism
MA Liya
LI Qingmin
FAN Lijuan
Abstract：Objective To explore the relationship between serum fructosamine(FA)and proprotein convertase subtilisin/kexin type 9(PCSK9)levels in subclinical hypothyroidism(SCH)patients during pregnancy and thyroid function and pregnancy outcomes.Methods From March 2022 to March 2023,65 pregnant women with SCH admitted to Kaifeng People's Hospital were retrospectively collected as the observation group,and 65 healthy pregnant women who underwent pregnancy tests were collected as the control group.Compare the differences in FA and PCSK9 levels between the two groups,analyze the correlation between serum FA and PCSK9 levels and related indicators of thyroid function,blood lipid and blood glucose,and to determine the correlation between FA and PCSK9 levels and different pregnancy outcomes in SCH patients.The differences in FA and PCSK9 levels between the two groups were compared,the correlations between serum FA and PCSK9 levels and thyroid function-related indicators,blood lipids and blood glucose were analyzed,the relationship between FA and PCSK9 levels and different pregnancy outcomes in SCH patients were determined,multivariate Logistic regression analysis was used to analyze whether FA and PCSK9 were independent risk factors with predictive value for the pregnancy outcomes of pregnant SCH patients,and draw the receiver operating characteristic curve to evaluate their predictive value.Pearson correlation analysis was performed to assess the associations of FA and PCSK9 levels with fasting plasma glucose(FPG),lipid profiles,and thyroid-stimulating hormone(TSH).Results Compared with the control group,the serum levels of FA,PCSK9,TSH,FPG,low density lipoprotein cholesterol(LDL-C),triglyceride(TG)and total cholesterol(TC)in the observation group were higher(P<0.001).The proportion of adverse pregnancy outcomes in the observation group was higher(23.08%vs 4.61%;χ2=9.286,P<0.05).The levels of FA and PCSK9 in the poor pregnancy group were higher than those in the good pregnancy group(in SCH patients during pregnancy[FA:C 194.92±21.04)mmol/L vs.(174.38±19.92)mmol/L,t=3.458,P<0.01;PCSK9:(110.96±13.39)μg/L vs.(90.60±12.44)μg/L,t=5.464,P<0.01].Serum FA and PCKS9 levels of SCH patients in the observation group were positively correlated with TSH,FBG,LDL-C,TG and TC,respectively(FA:r=0.514,0.389,0.449,0.612,0.481;PCSK:r=0.437,0.319,0.501,0.571,0.514;P<0.001).Mutivariate Logistic regression analysis showed that high levels of FA and PCSK9 were risk factors for adverse pregnancy outcomes in SCH patients(P<0.001).The ROC curve showed that the area under the curve(AUC)of serum FA and PCSK9 combined in predicting pregnancy outcome of SCH patients during pregnancy was 0.844,with a sensitivity of 93.33%and a specificity of 76.00%,the AUC of the combined prediction of FA and PCSK9 of pregnancy outcome was obviously greater than that of FA and PCSK9 alone(P<0.001).Conclusions Serum FA and PCSK9 levels increase in SCH patients during pregnancy,and are closely related to thyroid function and adverse pregnancy outcomes.
Keywords：pregnancysubclinical hypothyroidismfructosamineproprotein convertase subtilisin/kexin type 9thyroid functionpregnancy outcome
Publication Date：2025-10-28
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：6( 380-385 )