Study on the Relationship Between Serum SIRT1,SIRT6,Glucolipid Metabolism and Pregnancy Outcome in Patients with Gestational Diabetes Mellitus Complicated with Preeclampsia

ZHAO Jing; LU Yi; CHEN Zhiyi

doi:10.13730/j.issn.2097-2148.2025.08.004

Abstract：Objective To investigate the relationship between serum silent information regulator protein 1(SIRT1),SIRT6 and glucolipid metabolism and pregnancy outcome in patients with gestational diabetes mellitus(GDM)complicated with preeclampsia(PE).Methods A total of 140 patients with GDM complicated with PE(GDM+PE group),70 patients with simple GDM(GDM group)and 70 healthy pregnant women(normal pregnant women group)were selected in author's hospital from January 2021 to April 2024,patients with GDM+PE were divided into poor group(n=47)and good group(n=93)according to the pregnancy outcome.Serum SIRT1,SIRT6 and glucolipid metabolism indexes were compared among the GDM+PE group,GDM group and the normal preg-nant women group;Pearson correlation analysis was used to analyze the correlation between serum SIRT1,SIRT6 and glucolipid metabolism indexes of pregnant women in GDM+PE group;multivariate Logistic regression was used to ana-lyze the influencing factors of adverse pregnancy outcomes in GDM+PE group;receiver operating characteristics(ROC)curve was used to analyze the predictive efficacy of serum SIRT1 and SIRT6 for adverse pregnancy outcomes in pregnant women with GDM and PE.Results There were significant differences in serum SIRT1,SIRT6 and glucolipid metabolism indexes among normal pregnant women group,GDM group and GDM+PE group(all P＜0.001);compared with the normal pregnant women group,the levels of SIRT1,SIRT6 and high density lipoprotein cholesterol(HDL-C)level of pregnant women in GDM group and GDM+PE group decreased,and those in the GDM+PE group were lower than those in GDM group,fasting plasma glucose(FPG),1 h plasma glucose after glucose administration,2 h plasma glucose after glucose administration,fasting insulin(FINS),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and homeostatic model assessment of insulin resistance(HOMA-IR)levels of pregnant women increased,and GDM+PE group were higher than GDM group(all P＜0.05).Pearson correla-tion analysis showed that SIRT1 and SIRT6 were negatively correlated with FPG,1h plasma glucose after glucose admin-istration,2h plasma glucose after glucose administration,FINS,HbA1c,TC,TG,LDL-C and HOMA-IR,and positive-ly correlated with HDL-C in GDM+PE group(all P＜0.001).Multivariate Logistic regression analysis showed that se-vere PE was an independent risk factor for adverse pregnancy outcomes,and increased SIRT1 and SIRT6 were independ-ent protective factors for adverse pregnancy outcomes(P＜0.05).ROC curve showed that the area under the curve of se-rum SIRT1 and SIRT6 combined to predict adverse pregnancy outcomes in pregnant women with GDM and PE was 0.883[95％confidence interval(CI):0.818-0.931],which was higher than 0.794(95％CI:0.718-0.858)and 0.786(95％CI:0.709-0.851)predicted by serum SIRT1 and SIRT6 alone.Conclusion The levels of serum SIRT1 and SIRT6 in GDM patients with PE decreased,which are closely related to glucolipid metabolism disorders and adverse pregnancy outcomes,and the combination of serum SIRT1 and SIRT6 has a high value in predicting pregnancy outcomes in GDM patients with PE.