Correlation between Serum Cystatin-C,CTRP5,CTRP9 and HbA1c in Patients with Gestational Diabetes Mellitus and Its Predictive Value for Ad-verse Perinatal Outcomes

MIAO Huanhuan; WANG Yanhua; LI Ya'nan; LIAN Lifen

doi:10.3969/j.issn.1002-3429.2024.16.009

Abstract：Objective To investigate the correlation between serum cystatin-C(CysC),complement C1q/tumor nec-rosis factor-related protein 5(CTRP5),complement C1q/tumor necrosis factor-related protein 9(CTRP9)and glycosylated hemoglobin(HbA1c)in patients with gestational diabetes mellitus(GDM),and their predictive value for adverse perinatal outcomes.Methods A total of 150 patients with GDM from January 2022 to December 2023 were selected as the research subjects and divided into adverse outcome group(n=41)and good outcome group(n=109)according to the perinatal out-comes.The baseline data and serum CysC,CTRP5,CTRP9,and HbA1c levels of the two groups were compared.Multivari-ate logistic regression analysis was used to analyze the influencing factors of adverse perinatal outcomes in GDM patients.Pear-son correlation analysis was used to analyze the correlation between CysC,CTRP5,CTRP9,and HbA1c.Receiver operating characteristic curve analysis was used to analyze the predictive value of each index for adverse outcomes,and the performance of each prediction scheme was compared.Results The differences in age,pre-pregnancy body mass index(BMI),pre-delivery BMI,mid-pregnancy oral glucose tolerance test results,and serum CysC,CTRP5,CTRP9,and HbA1c levels be-tween the adverse outcome group and the good outcome group were statistically significant(P＜0.05).After adjusting for oth-er relevant factors,serum CysC,CTRP5,CTRP9,and HbA1c remained as influencing factors for adverse perinatal outcomes in patients with GDM(P＜0.05).Serum CysC and CTRP5 were positively correlated with HbA1c in GDM patients,while CTRP9 was negatively correlated with HbA1c(P＜0.05).The area under the curve of serum CysC,CTRP5,and CTRP9 in combination for the prediction of adverse perinatal outcomes in GDM patients was 0.936(95%CI:0.885,0.970),which was superior to the predictive value of each individual indicator and the combination of two indicators.Conclusion CysC and CTRP5 expression are upregulated in the serum of GDM patients,while CTRP9 expression is downregulated;each indicator is correlated with HbA1c.Combined detection of the three indicators has certain predictive value for adverse perinatal outcomes and can be used as an auxiliary indicator for clinical evaluation of glycemic control and prediction of perinatal outcomes.