关键词: 妊娠期糖尿病, 巨大儿, 载脂蛋白B, 载脂蛋白A1, 预测价值

Abstract: Objective To explore the predictive value of apolipoprotein B（Apo-B）and apolipoprotein A1（Apo-A1）levels on delivery of macrosomia in patients with gestational diabetes mellitus（GDM）．Methods From January 2023 to January 2024,85 patients with GDM who were filed in the hospital and received pregnancy examination and delivery were selected．According to the neonatal body mass,the patients were divided into 55 cases in normal delivery group（newborn birth weight < 4 000 g）and 30 cases in abnormal delivery group（ newborn birth weight ≥4 000 g）．The general data and levels of Apo-B,Apo-A1 and Apo-B/Apo-A1 in early pregnancy were compared between the two groups．Receiver operating characteristic（ROC）curve was used to analyze the predictive value of Apo-B,Apo-A1 and Apo-B/Apo-A1 on delivery of macrosomia in GDM patients．Results The Apo-B and Apo-B/Apo-A1 in abnormal delivery group were（1.05±0.15）g/L and（0.81±0.23）,which were higher than（0.95±0.12）g/L and（0.65±0.18）in normal delivery group（t=3.357,3.544,P<0.05）．While the level of Apo-A1 in abnormal delivery group,（1.29±0.26）g/L,was lower than（1.47±0.23）g/L in normal delivery group（t=3.292,P<0.05）．ROC curve showed that the areas under the curve（AUC）of Apo-B,Apo-A1 and Apo-B/Apo-A1 in predicting macrosomia in GDM patients were 0.705,0.660 and 0.709,and the sensitivities were 63.33%,63.33% and 66.67%,and the specificities were 72.73%,74.55% and 76.36%,respectively．Apo-B/Apo-A1 had the highest predictive efficiency（P<0.05）．Conclusions The delivery of macrosomia in GDM patients is closely related to the increase of Apo-B and the decrease of Apo-A1 in early pregnancy．Monitoring Apo-B,Apo-A1 and Apo-B/Apo-A1 in early pregnancy is helpful to predict the delivery of macrosomia．

Key words: gestational diabetes mellitus, macrosomia, apolipoprotein B, apolipoprotein A1, predictive value