Correlations of asprosin and cyclophilin A levels with intestinal flora plus pregnancy outcome in patients with gestational diabetes mellitus

Introduction: Background and objective: gestational diabetes mellitus (GDM) is associated with altered metabolic and inflammatory pathways as well as adverse pregnancy outcomes. This study aimed to analyze the correlations of asprosin and cyclophilin A (CyPA) levels with intestinal flora and pregnancy outcome in patients with GDM. Methods: a total of 125 patients with GDM (GDM group) admitted between January 2022 and July 2024 and 125 healthy subjects (healthy group) undergoing physical examination were enrolled. Serum asprosin and CyPA levels were measured, and their correlations with blood glucose, insulin resistance and intestinal flora were analyzed using Pearson's analysis. Within the GDM group, patients were subdivided into those with good pregnancy outcomes and those with poor pregnancy outcomes based on follow-up results. Results: compared with the healthy group, patients with GDM exhibited higher levels of glycosylated hemoglobin A1c (HbA1c), 2 h postprandial blood glucose (2hPG), fasting blood glucose (FBG), fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR) (all p < 0.05). Elevated levels of 2hPG, FBG, HbA1c, HOMA-IR, FINS, Enterococcus, Enterobacter and yeast were identified as risk factors for adverse pregnancy outcomes (odds ratio (OR) > 1, p < 0.05), while increased Lactobacillus and Bifidobacterium served as protective factors (OR < 1, p < 0.05). The areas under the receiver operating characteristic curves of asprosin, CyPA and their combination in predicting pregnancy outcomes were 0.793 (95 % confidence interval (CI): 0.689-0.896), 0.801 (95 % CI: 0.698-0.904) and 0.842 (95 % CI: 0.737-0.947), respectively. Conclusion: serum asprosin and CyPA levels are elevated in GDM patients and are closely associated with blood glucose, insulin resistance and intestinal flora. Combined detection of asprosin and CyPA may improve the predictive value for adverse pregnancy outcomes in GDM.