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Received:March 12, 2023 Published Online:April 20, 2025
Received:March 12, 2023 Published Online:April 20, 2025
中文摘要: 目的 探讨妊娠期糖尿病（GDM）产妇血清和新生儿脐血清中胰岛素样生长因子1（IGF-1）、IGF-1受体（IGF-1R）及脑源性神经营养因子（BDNF）水平，以及它们对新生儿脑损伤的影响。方法 选取2020年9月至2023年9月延安大学附属医院住院分娩的87例GDM产妇作为观察组，另选同期住院分娩的87例健康产妇作为对照组，比较两组产妇血清和新生儿脐血清IGF-1、IGF-1R、BDNF水平。采用新生儿20项行为神经评分法（NBNA）评估新生儿脑损伤情况；采用受试者工作特征（ROC）曲线分析GDM产妇血清及新生儿脐血清IGF-1、IGF-1R和BDNF水平对新生儿脑损伤的预测价值。结果 观察组新生儿脑损伤发生率高于对照组（13.79% vs 2.30%, χ2=7.768， P=0.005）。观察组NBNA评分各维度得分均低于对照组（P＜0.01）。观察组产妇血清及新生儿脐血清IGF-1、BDNF水平低于对照组，IGF-1R水平高于对照组（P＜0.01）。ROC曲线结果显示，产妇血清IGF-1、IGF-1R、BDNF和新生儿脐血清IGF-1、IGF-1R、BDNF预测新生儿脑损伤的AUC分别为0.668、0.698、0.656和0.761、0.709、0.666。结论 GDM产妇血清及新生儿脐血清IGF-1、BDNF与IGF-1R水平与新生儿脑损伤的发生相关。临床可通过监测产妇IGF-1、BDNF、IGF-1R水平的变化预测新生儿脑损伤发生的可能性。
Abstract:Objective To investigate the serum levels of insulin-like growth factor 1 (IGF-1), IGF-1 receptor (IGF-1R), and brain-derived neurotrophic factor (BDNF) in pregnant women with gestational diabetes mellitus (GDM) and neonatal umbilical cord blood, and their effects on neonatal brain injury. Methods A total of 87 GDM pregnant women hospitalized for delivery at Yan'an University Affiliated Hospital from September 2020 to September 2023 were selected as the observation group. An additional 87 healthy pregnant women with normal deliveries during the same period were selected as the control group. Serum IGF-1, IGF-1R, and BDNF levels in the pregnant women and neonatal umbilical cord blood were compared between the two groups. Neonatal brain injury was assessed using the Neonatal Behavioral Neurological Assessment (NBNA) scale. Analysis of receiver operating characteristic (ROC) curve was performed to evaluate the predictive value of maternal serum and neonatal umbilical cord serum IGF-1, IGF-1R, and BDNF levels for neonatal brain injury. Results The incidence of neonatal brain injury in the observation group was higher than that in the control group (13.79% vs 2.30%, χ2=7.768, P=0.005). NBNA scores across all dimensions were lower in the observation group compared to the control group (P＜0.01). Maternal serum IGF-1 and BDNF levels were lower, while IGF-1R levels were higher in the observation group than in the control group (P＜0.05). Neonatal umbilical cord serum IGF-1 and BDNF levels were lower, and IGF-1R levels were higher in the observation group than in the control group (P＜0.01). ROC curve analysis showed that the area under the curve (AUC) for maternal serum IGF-1, IGF-1R, BDNF, and neonatal umbilical cord serum IGF-1, IGF-1R, BDNF in predicting neonatal brain injury was 0.668, 0.698, 0.656, 0.761, 0.709, and 0.666, respectively. Conclusion Pregnant women's serum and neonatal umbilical cord serum levels of IGF-1、 BDNF and IGF-1R are correlated with neonatal brain injury. Clinically, monitoring changes in maternal IGF-1, BDNF, and IGF-1R levels can help predict the incidence of neonatal brain injury.
keywords: Gestational diabetes mellitus Insulin-like growth factor 1 Insulin-like growth factor 1 receptor Brain-derived neurotrophic factors Neonatal behavioral neurological assessment Neonatal brain injury Umbilical cord blood
文章编号： 中图分类号：R714.256 文献标志码：A
基金项目:2022年度延安市科技计划项目（2022SLSFGG-047）
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