Correlation Study Of FINS,HOMI And TyG Index In Early Pregnancy To Predict The Development Of Gestational Diabetes Mellitus

Objective:To explore the correlation between peripheral blood fasting insulin（FINS）,homeostasis model assessment of insulin resistance（HOMA-IR）,homeostasis model assessment of isletβ-cell function（HOMA-β）and triglyceride-glucose（Ty G）index of pregnant women in early pregnancy and the occurrence of GDM in the second and third trimesters,and analyze the predictive value of the above indexes for the occurrence of GDM in the second and third trimesters,so as to detect and prevent GDM early and reduce the adverse pregnancy outcome caused by GDM in mother and child.Methods:Pregnant women who underwent regular antenatal check-up in obstetrics clinic of the Second Hospital of Jilin University from October 2021 to September 2022were selected.FINS,fasting plasma glucose（FPG）and triglyceride（TG）in peripheral blood of pregnant women were detected at 10-14 weeks of gestation,and HOMA-IR,HOMA-βand Ty G index were calculated.A 75g oral glucose tolerance test（OGTT）was performed at 24-28 weeks of gestation,and the patients were divided into case group（GDM group）and control group（normal glucose tolerance,NGT group）according to the result of 75g OGTT.According to inclusion and exclusion criteria,102 cases were included（39 cases in the GDM group and 63cases in the NGT group）.The differences of FINS,FPG,TG,HOMA-IR,HOMA-βand Ty G index in early pregnancy between the two groups were compared respectively.The regression prediction model was established by logistic regression analysis,then independent risk factors of GDM were analyzed.Receiver operating characteristic（ROC）curve was drawn.The prediction value of the above indexes to the occurrence of GDM was analyzed.Results:1.Age,gestational time,systolic and diastolic blood pressure,the gestational age during which blood is obtained in the first trimester,and the gestational age of the 75g OGTT trial were not significantly different between the two groups（P>0.05）.The body mass index（BMI）in the GDM group was higher than that in the NGT group,and the difference was statistically significant（P<0.05）.2.A comparative analysis of FINS,FPG,TG,HOMA-IR,HOMA-βand Ty G index in early pregnancy between the GDM group and the NGT group showed that the GDM group’s average FINS was（11.92±3.13）m IU/L,average FPG was（4.96±0.33）mmol/L,average TG was（1.89±0.53）mmol/L,average HOMA-IR was2.64±0.70,average HOMA-βwas 170.14±59.70 and average Ty G index was 8.88±0.29.The NGT group’s average FINS were（8.35±2.38）m IU/L,average FPG was（4.76±0.20）mmol/L,average TG was（1.51±0.40）mmol/L,average HOMA-IR was 1.77±0.52,average HOMA-βwas 134.86±43.43 and average Ty G index was 8.62±0.28.The above indexes were statistically significant（P<0.05）.3.Binary logistic regression analysis showed that BMI,FINS,FPG,TG,HOMA-IR and Ty G index at 10-14 weeks gestation were independent risk factors for predicting the development of GDM（P<0.05）.HOMA-βhad no significant effect on the occurrence of GDM（P>0.05）.When FINS,FPG,TG and BMI were included to construct a regression model for predicting GDM（GDM1 prediction model for short）,the goodness of fit effect of the model was not good.When HOMA-IR,Ty G index and BMI were included to construct a regression model for predicting GDM（GDM2 prediction model for short）,the goodness of fit effect of the model was poor.When FINS,Ty G index and BMI were included to construct a regression model for predicting GDM（GDM3 prediction model for short）,the goodness of fit effect of the model was the best.The prediction model calculation equation:P_GDM3=1/(1+e^-y′′),y′′=-45.52+0.52×FINS+2.53×Ty G index+0.75×BMI.4.The relative indexes were put into ROC curve.The results showed that the area under curve of FINS,HOMA-IR,Ty G index and GDM3 prediction model in early pregnancy were 0.828,0.853,0.736 and 0.885,respectively.These results indicated that FINS,HOMA-IR and Ty G index had good predictive value for the occurrence of GDM.The predictive value of FINS and HOMA-IR was better than that of Ty G index,while the predictive value of GDM3 prediction model was better than that of a single index.Conclusions:1.Increased levels of FINS,HOMA-IR,HOMA-βand Ty G index in early pregnancy were associated with GDM,while FINS,HOMA-IR and Ty G index were independent risk factors for predicting the occurrence of GDM.2.FINS,HOMA-IR and Ty G index in early pregnancy have good predictive value for the occurrence of GDM,and the combined independent risk factor indexes in early pregnancy have better predictive value for GDM than a single index.