国际妇产科学杂志

国际妇产科学杂志 ›› 2026, Vol. 53 ›› Issue (1): 113-116.doi: 10.12280/gjfckx.20250664

• 产科生理及产科疾病: 论著 • 上一篇    下一篇

血清IGF1、SHBG对妊娠期糖尿病患者产后糖代谢转归的预测价值

宋杰(), 高亚梅, 张丽红   

  1. 066000 河北省秦皇岛市妇幼保健院妇产科
  • 收稿日期:2025-06-17 出版日期:2026-02-15 发布日期:2026-03-11
  • 通讯作者: 宋杰 E-mail:y3l8e3@sina.com

Predictive Value of Serum IGF1 and SHBG for Postpartum Glucose Metabolism Outcomes in Gestational Diabetes Mellitus

SONG Jie(), GAO Ya-mei, ZHANG Li-hong   

  1. Department of Obstetrics and Gynecology, Qinhuangdao Maternal and Child Health Hospital, Qinhuangdao 066000, Hebei Province, China
  • Received:2025-06-17 Published:2026-02-15 Online:2026-03-11
  • Contact: SONG Jie E-mail:y3l8e3@sina.com

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摘要：

目的：探究血清胰岛素样生长因子1（insulin-like growth factor 1，IGF1）、性激素结合球蛋白（sex hormone-binding globulin，SHBG）对妊娠期糖尿病（gestational diabetes mellitus，GDM）患者产后糖代谢转归的预测价值。方法：选取2022年6月—2024年10月我院收治的120例妊娠晚期GDM患者作为GDM组，依据患者产后糖代谢转归情况分为异常组（48例）和正常组（72例），同期120例健康孕妇为对照组。采用酶联免疫吸附分析（enzyme-linked immunosorbent assay，ELISA）检测血清IGF1和SHBG水平；比较GDM组与对照组及正常组与异常组的基础资料及血清IGF1、SHBG水平；多因素Logistic回归分析GDM患者产后糖代谢转归异常的影响因素；受试者工作特征（receiver operating characteristic，ROC）曲线分析血清IGF1、SHBG水平对GDM患者产后糖代谢转归异常的预测价值。结果：GDM组血清IGF1水平高于对照组，血清SHBG水平低于对照组（均P<0.05）。异常组甘油三酯（triglyceride，TG）和血清IGF1水平高于正常组，血清SHBG水平低于正常组（均P<0.05）。血清IGF1、SHBG水平是GDM患者产后糖代谢转归异常的影响因素（均P<0.05）。血清IGF1、SHBG水平联合预测GDM患者产后糖代谢转归异常的价值高于单一指标单独预测（均P<0.05）。结论：GDM产后糖代谢转归异常患者血清IGF1水平升高，血清SHBG水平降低，二者联合预测患者产后糖代谢转归异常的价值较高。

关键词: 糖尿病，妊娠, 血糖, 胰岛素样生长因子Ⅰ, 性激素结合球蛋白, 预测

Abstract:

Objective: To evaluate the predictive utility of serum insulin-like growth factor 1 (IGF1) and sex hormone-binding globulin (SHBG) for postpartum glucose metabolism outcomes in patients with gestational diabetes mellitus (GDM). Methods: 120 women with GDM in the third trimester (GDM group) and 120 healthy pregnant controls (control group) were recruited between June 2022 and October 2024. According to postpartum glucose status, the GDM cohort was subdivided into an abnormal outcome group (n=48) and a normal outcome group (n=72). Serum IGF1 and SHBG levels were quantified by enzyme-linked immunosorbent assay (ELISA). Baseline characteristics and biochemical parameters were compared between the GDM and control groups, and between the abnormal and normal outcome subgroups. Multivariate logistic regression was used to identify determinants of impaired postpartum glucose metabolism. Receiver operating characteristic (ROC) curve analysis assessed the predictive performance of serum IGF1 and SHBG, individually and in combination. Results: Serum IGF1 was higher and SHBG was lower in the GDM group than in the control group (both P<0.05). Women in the abnormal outcome subgroup exhibited higher triglyceride (TG) and IGF1 levels and lower serum SHBG levels compared with the normal outcome subgroup (all P<0.05). Both IGF1 and SHBG were independent predictors of postpartum glucose metabolism impairment (both P<0.05). The combined model of serum IGF1 and SHBG had a higher value in predicting abnormal postpartum glucose metabolism glucose in GDM patients than single indicators alone (both P<0.05). Conclusions: Elevated serum IGF1 and reduced SHBG are associated with abnormal postpartum glucose metabolism in GDM. Their combined measurement offers superior predictive accuracy for identifying women with high risk of persistent glucose dysregulation after delivery.

Key words: Diabetes, gestational, Blood glucose, Insulin-like growth factor Ⅰ, Sex hormone-binding globulin, Forecasting