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Correlation of PI3K/AKT signaling pathway-related factors with abnormal glucose tolerance and insulin resistance in women during pregnancy |
SHEN Xiaojing, LI Fang, SHI Xunting |
Department of Endocrinology, Chuzhou First People's Hospital, Chuzhou 23900 |
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Abstract Objective To investigate the correlation between factors related to the phosphatidylinositol 3-kinase (PI3K) /serine threonine protein kinase (AKT) signaling pathway and abnormal glucose tolerance and insulin resistance in women during pregnancy. Methods Seventy-five pregnant women with abnormal glucose tolerance during pregnancy in our hospital from March 2020 to March 2022 were selected as the study group, and another 75 pregnant women with normal glucose tolerance during the same period were selected as the control group. The clinical data, PI3K/AKT signaling pathway markers [PI3K, phosphorylated AKT (p-AKT) ], fasting blood glucose (FPG), insulin resistance index (Homa - insulin resistance, HOMA-IR) were compared between the two groups, and the effects of PI3K and p-AKT on abnormal glucose tolerance in women during pregnancy were analyzed by interaction. Pearson correlation coefficient was used to analyze the correlation between PI3K and p-AKT levels and FPG and HOMA-IR in pregnant women with abnormal glucose tolerance during pregnancy. The clinical data and serum PI3K, p-AKT, FPG levels and HOMA-IR of pregnant women with simple glucose tolerance abnormalities and pregnant women with gestational diabetes mellitus (GDM) in the study group were compared, and the factors influencing GDM were analyzed by logistic multi-factor regression model, and the value of serum PI3K and p-AKT levels in predicting GDM was analyzed by subject work characteristic (ROC) curve. RESULTS: Serum PI3K levels were lower in the study group than in the control group, and serum p-AKT, FPG levels and HOMA-IR were higher than in the control group; low PI3K levels and high p-AKT levels showed a positive interaction in a superphase multiplicative model of glucose tolerance abnormalities in pregnant women; serum PI3K levels in pregnant women with glucose tolerance abnormalities in pregnancy were negatively correlated with FPG, HOMA-IR, and p-AKT levels were negatively correlated with FPG and HOMA-IR. Body mass index, family history of diabetes, serum p-AKT, FPG levels and HOMA-IR were higher in pregnant women with GDM than in pregnant women with simple glucose tolerance abnormalities, and serum PI3K levels were lower than in pregnant women with simple glucose tolerance abnormalities; body mass index, family history of diabetes, serum PI3K and p-AKT levels were all influencing factors for GDM; serum The area under the curve (AUC) for the prediction of GDM by serum PI3K and p-AKT levels were all>0.7, and the AUC for the combined prediction of the two was the largest at 0.916, and the sensitivity and specificity of the prediction were 90.62% and 80.13%, respectively. Conclusion Changes in the levels of PI3K and p-AKT, markers of PI3K/AKT signaling pathway, are closely associated with abnormal glucose tolerance and insulin resistance in women during pregnancy, and their combination has good predictive efficacy in predicting GDM.
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Received: 07 March 2023
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