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已发表论文
妊娠期糖尿病患者胰岛素抵抗作为盆腔器官脱垂的生物标志物：按分娩方式分层
Authors Jiao Y, Dai Y, He L, Fei Z
Received 21 March 2025
Accepted for publication 8 September 2025
Published 21 October 2025 Volume 2025:18 Pages 6377—6385
DOI https://doi.org/10.2147/IJGM.S529756
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Vinay Kumar
Ying Jiao,1,* YongGang Dai,2,* Lin He,3 Zhiyi Fei4
1Department of Gynecology, The No.2 Hospital of Baoding, Baoding, Hebei, 071051, People’s Republic of China; 2Department of Clinical Laboratory, Shandong Provincial Third Hospital, Jinan, Shandong, 250031, People’s Republic of China; 3Department of Gynecology, Tianjin Occupational Diseases Precaution and Therapeutic Hospital, Tianjin, 300011, People’s Republic of China; 4Department of Obstetrics and Gynecology, Wuhan Puren Hospital, Wuhan, Hubei, 430081, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhiyi Fei, Department of Obstetrics and Gynecology, Wuhan Puren Hospital, No. 1 Benxi Street, Qingshan District, Wuhan, Hubei, 430081, People’s Republic of China, Email feizhiyi2045@163.com
Objective: This study was to observe the assessment value of insulin and insulin resistance level on pelvic organ prolapse (POP) in women with gestational diabetes mellitus (GDM) who experienced different delivery modes, and to analyze the association between insulin and insulin resistance level and pelvic organ prolapse in GDM.
Methods: 150 GDM patients were selected as the observation group, with 150 healthy pregnant women as the control group. PG and HOMA-IR levels were compared between groups. Correlation analysis was conducted with Pearson method. Logistic regression was used to analyze the relationship between serum insulin and insulin resistance levels and POP in patients with GDM. The value of serum insulin and insulin resistance levels in predicting POP in patients with GDM was analyzed by ROC curves, and area under the curve (AUC) was compared by the Z test.
Results: POP was detected in 148 out of 300 cases (49.3%), with a prevalence of 62.0% in the GDM group compared to 36.7% in the control group. PG and HOMA-IR levels were higher in GDM patients with POP. BMI ≥ 24 kg/m2, number of deliveries > 2, number of pregnancies > 2, gestational week ≥ 37 weeks, fetal weight ≥ 4 kg, mode of delivery, PG and HOMA-IR were risk factors for POP in patients with GDM. The AUC of PG for predicting POP in patients with GDM was 0.835 (95% CI: 0.702~0.845), and the AUC of HOMA-IR was 0.848 (95% CI: 0.768~0.922).
Conclusion: Insulin and insulin resistance levels are associated with POP in women with GDM with different modes of delivery, and their combined assessment may increase the predictive value for POP.
Keywords: gestational diabetes mellitus, insulin resistance, pelvic organ prolapse, vaginal birth, cesarean section
1Department of Gynecology, The No.2 Hospital of Baoding, Baoding, Hebei, 071051, People’s Republic of China; 2Department of Clinical Laboratory, Shandong Provincial Third Hospital, Jinan, Shandong, 250031, People’s Republic of China; 3Department of Gynecology, Tianjin Occupational Diseases Precaution and Therapeutic Hospital, Tianjin, 300011, People’s Republic of China; 4Department of Obstetrics and Gynecology, Wuhan Puren Hospital, Wuhan, Hubei, 430081, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhiyi Fei, Department of Obstetrics and Gynecology, Wuhan Puren Hospital, No. 1 Benxi Street, Qingshan District, Wuhan, Hubei, 430081, People’s Republic of China, Email feizhiyi2045@163.com
Objective: This study was to observe the assessment value of insulin and insulin resistance level on pelvic organ prolapse (POP) in women with gestational diabetes mellitus (GDM) who experienced different delivery modes, and to analyze the association between insulin and insulin resistance level and pelvic organ prolapse in GDM.
Methods: 150 GDM patients were selected as the observation group, with 150 healthy pregnant women as the control group. PG and HOMA-IR levels were compared between groups. Correlation analysis was conducted with Pearson method. Logistic regression was used to analyze the relationship between serum insulin and insulin resistance levels and POP in patients with GDM. The value of serum insulin and insulin resistance levels in predicting POP in patients with GDM was analyzed by ROC curves, and area under the curve (AUC) was compared by the Z test.
Results: POP was detected in 148 out of 300 cases (49.3%), with a prevalence of 62.0% in the GDM group compared to 36.7% in the control group. PG and HOMA-IR levels were higher in GDM patients with POP. BMI ≥ 24 kg/m2, number of deliveries > 2, number of pregnancies > 2, gestational week ≥ 37 weeks, fetal weight ≥ 4 kg, mode of delivery, PG and HOMA-IR were risk factors for POP in patients with GDM. The AUC of PG for predicting POP in patients with GDM was 0.835 (95% CI: 0.702~0.845), and the AUC of HOMA-IR was 0.848 (95% CI: 0.768~0.922).
Conclusion: Insulin and insulin resistance levels are associated with POP in women with GDM with different modes of delivery, and their combined assessment may increase the predictive value for POP.
Keywords: gestational diabetes mellitus, insulin resistance, pelvic organ prolapse, vaginal birth, cesarean section