摘要
目的 探讨妊娠期糖尿病（GDM）发病的危险因素..方法 2012年9月1日至2013年4月19日在北京大学第一医院行75 g口服葡萄糖耐量试验（OGTT）孕妇427例,其中诊断为GDM74例（GDM组）,非GDM孕妇353例（非GDM组）.收集两组孕妇临床资料进行多因素logistic回归分析,临床资料包括孕妇年龄,孕前体质量及体质指数（BMI）,孕11～12周时体质量,孕23～24周时体质量,早孕期空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TCH）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、空腹胰岛素（FINS）水平,稳态模型评估法计算的胰岛素抵抗指数（HOMA-IR）.结果 （1）GDM组孕妇与非GDM组比较,在孕妇年龄、孕前BMI、早孕期FPG、TG、FINS及HOMA-IR、早孕期及中孕期体质量增长方面,差异均有统计学意义（P＜0.05）.GDM组孕妇与非GDM组有糖尿病家族史者分别为29例（39％,29/74）及72例（20.4％,72/353）,两组比较,差异有统计学意义（P＜0.01）.（2）对GDM发病有统计学意义的危险因素包括：早孕期FPG水平（OR=4.03,95％ CI为1.62～10.02）、糖尿病家族史（OR=3.15,95％ CI为1.66 ～ 5.99）、早孕期TG水平（OR =2.13,95％ CI为1.17 ～3.87）、孕前BMI（OR=1.36,95％ CI为1.08 ～ 1.70）、年龄≥35岁（OR=1.15,95％ CI为1.05 ～ 1.26）、早孕体质量增长（OR=1.20,95％ CI为1.06 ～ 1.35）、中孕期体质量增长（OR=1.28,95％ CI为1.12 ～1.47）、早孕期FINS水平（OR=1.09,95％ CI为1.01 ～1.17）.结论 孕妇早孕期FPG、TG及FINS水平,孕前BMI、早孕期及中孕期体质量增长,年龄≥35岁、糖尿病家族史等因素为GDM发病的独立危险因素.对孕妇产前保健中应提高对早孕期FPG、TG水平的重视,于早孕期启动孕妇体质量管理,合理控制孕期体质量增长.
Objective To assesment the effect of risk factors at gestational diabetes mellitus （GDM）.Methods We collected 427 pregnant women who had done 75 g oral glucose tolerance test （OGTT） between September 1st,2012 and April 19th,2013 in Peking University First Hospital,including 74 pregnant women diagnosed as GDM （GDM group） and 353 pregnant women undiagnosed （non-GDM group）.Then we conducted a multiple logistic regression to analyze the clinical datas collected from two groups,which included age,pre-pregnancy body weight and body mass index （BMI）,body weight during 11-12 weeks pregnancy,body weight during 23-24 weeks pregnancy; and fasting plasma glucose（FPG）,triglyceride （TG）,total cholesterol （TCH）,high density lipoprotein （H DL）,low density lipoprotein （LDL）,fasting insulin （FINS）,homeostasis model assessment of insulin resistance （HOMA-IR） during early pregnancy; and family history of diabetes mellitus.Results （1）There were significant difference in age,pre-pregnancy BMI,and FPG,TG,FINS,HOMA-IR during early pregnancy,and family history of diabetes mellitus between two groups （P 〈 0.05）.（2） The risk factors of GDM that have statistical significance included FPG during early pregnancy （OR：4.03,95 % CI：1.62-10.02）,family history of diabetes mellitus （OR：3.15,95 % CI：1.66-5.99）,TG during early pregnancy （OR：2.13,95 % CI：1.17-3.87）,BMI before pregnancy （OR：1.36,95 % CI：1.08-1.70）,age ≥ 35 years （OR：1.15,95 % CI：1.05-1.26）,early pregnancy weight gain （OR：1.20,95% CI：1.06-1.35）,mid pregnancy weight gain （OR：1.28,95% CI：1.12-1.47）,FINS during early pregancy （OR：1.09,95% CI：1.01-1.17）.Conclusions FPG,TG and FINS during early pregnancy,BMI before pregnancy,early and mid pregnancy weight gain,family history of diabetes mellitus and age≥35 years are the indepadent risk factors for GDM.We should pay more attention to FPG and TG during early pregnancy,and put weight management into practise since early pregnancy and try to control pregnancy weight gain within reasonable limits.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2014年第5期321-324,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
糖尿病
妊娠
体重增长
危险因素
Diabetes,gestational
Weight gain
Risk factors
