Predictive Value of Cystatin C Combined with Ferritin Detection in Mid-pregnancy for Adverse Pregnancy Outcomes in Pa-tients with Gestational Diabetes Mellitus

WANG Dan; XUE Cailian; LI Qionghua; SONG Chengwen; YI Fengtao

doi:10.13730/j.issn.2097-2148.2024.07.010

Abstract：Objective To explore the predictive value of cystatin C(Cys-C)combined with serum ferritin(SF)de-tection in mid-pregnancy for adverse pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods The clinicl data of 159 GDM patients in author's hospital from March 2015 to March 2023 were retrospectively analyzed,and they were divided into adverse pregnancy outcome group(n=31)and good pregnancy outcome group(n=128)according to the final pregnancy outcomes of the patients.The age,parity,pre-pregnancy body mass index(BMI),mid-pregnancy BMI,adverse pregnancy and childbirth history,family history of diabetes mellitus,history of hypertension and history of hyperlipidemia of the GDM patients were collected,and the mid-pregnancy serum Cys-C,SF and glycosy-lated hemoglobin A1 c(HbA1 c)level of the GDM patients were detected;the risk factors of adverse pregnancy outcomes in GDM patients were analyzed by Logistic regression model;the predictive value of Cys-C,SF and combined detection of the two for adverse pregnancy outcomes in patients with GDM were evaluated by the receiver operating characteristic(ROC)curve.Results Compared with the good pregnancy outcome group,there were no statistical differences in age,parity,mid-pregnancy BMI,adverse pregnancy and childbirth history,family history of diabetes mellitus,history of hy-pertension and history of hyperlipidemia in the adverse pregnancy outcome group(P＞0.05),while the levels of mid-pregnancy Cys-C,SF,HbA1c and mid-pregnancy BMI significantly increased(all P＜0.05).Logistic regression analysis results showed that the increased expression levels of HbA1 c,Cys-C and SF were risk factors for the increased risk of ad-verse pregnancy outcomes in GDM patients.The results of the ROC curve showed that the area under the curve(AUC)of mid-pregnancy Cys-C and SF predicting adverse pregnancy outcomes in GDM patients were 0.743 and 0.783 respectively,the sensitivities were 86.59％and 86.67％re-spectively and the specificities were 63.89％and 66.67％re-spectively,and the AUC of the combination of the two was 0.798,the sensitivity was 86.67％and the specificity was 72.22％,which was better than single test of Cys-C or SF.Conclusion Cys-C combined with SF detection in mid-pregnancy has a good predictive value in assessing pregnancy out-comes in patients with GDM.