摘要
目的:探讨妊娠期肝内胆汁淤积症(ICP)与妊娠期糖尿病(GDM)的相关性。方法:选取2013年2月至2021年2月在北京大学深圳医院产科分娩的GDM孕妇5517例(GDM组)和非GDM孕妇5517例(非GDM组),采用单因素、多因素和分层分析法分析ICP与GDM、ICP与血糖水平、总胆汁酸与GDM的相关性。结果:GDM组中ICP比例显著大于非GDM组,差异有统计学意义(P<0.05)。GDM合并ICP患者的OGTT-1h血糖显著高于GDM未合并ICP患者(P<0.05),两组患者OGTT-0h或2h血糖比较,差异无统计学意义(P>0.05)。与非GDM组比较,GDM组中重度ICP占ICP总体的比例显著增高(34.88%vs 9.68%,P<0.001);ICP病例中,与未合并GDM患者比较,合并GDM的患者血清总胆汁酸显著升高(中位数29.10μmol/L vs 20.65μmol/L,P<0.01)。多因素分析提示,ICP与GDM显著相关(OR=1.426,95%CI为1.011~2.011,P=0.043),这与非高龄妊娠、单胎妊娠、经产妇中的分层分析结果一致。结论:ICP与GDM存在显著相关性,并且这种相关性在重度ICP中更明显,ICP可能是GDM的风险因素之一。
Objective:To investigate the correlation between intrahepatic cholestasis of pregnancy(ICP)and gestational diabetes mellitus(GDM).Methods:5517 cases of GDM(GDM group)and 5517 cases of non-GDM(non-GDM group)in Peking University Shenzhen Hospital from February 2013 to February 2021 were selected.Using univariate,multivariate,and stratified analysis,the relationship between ICP and GDM was explored.The correlation between ICP and blood glucose levels,as well as the correlation between total bile acid levels and GDM were also analyzed.Results:The proportion of ICP in the GDM group was significantly higher than that in the non-GDM group(P<0.05).Cases with GDM and ICP had significantly higher OGTT-1 hour blood glucose levels compared to those ICP cases without GDM(P<0.05).However,there was no statistically significant difference in OGTT-0 hour or 2 hour blood glucose levels between the two groups(P>0.05).In the GDM group,the proportion of severe ICP in the total ICP cases was significantly higher than that in the non-GDM group(34.88%vs 9.68%,P<0.001).Among ICP cases,cases with GDM showed a significant increase in serum total bile acids(median 29.10μmol/L)compared to cases without GDM(median 20.65μmol/L).Multivariate analysis revealed a significant correlation between ICP and GDM(OR=1.426,95%CI:1.011~2.011,P=0.043),which was consistent with the stratification analysis results for non-advanced pregnancy,singleton pregnancy,and multipara pregnancy.Conclusion:There is a significant correlation between ICP and GDM,particularly in severe ICP.ICP may be considered as a risk factor for GDM.
作者
钟世林
杨璈
刘育祯
程威
邓玉清
Zhong Shilin;Yang Ao;Liu Yuzhen(Department of Obstetrics and Gynecology,Peking University Shenzhen Hospital,Shenzhen 518036;Institute of Obstetrics and Gynecology,Shenzhen PKU-HKUST Medical Center,Shenzhen 518036;Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases,Shenzhen 518036)
出处
《现代妇产科进展》
2024年第1期21-25,共5页
Progress in Obstetrics and Gynecology
基金
深圳市科技计划项目资助(No:JCYJ20210324110206017)
北京大学深圳医院科研项目(No:LCYJ2021010)
深圳市高水平医院建设专项经费资助(No:粤办函[2019]260号)
深圳市“医疗卫生三名工程”项目资助(No:SZSM202011016)。
关键词
妊娠期糖尿病
妊娠期肝内胆汁淤积症
血糖
总胆汁酸
相关性
Gestational diabetes mellitus
Intrahepatic cholestasis of pregnancy
Blood glucose
Total bile acid
Correlation
