中国妇幼健康研究2018，Vol.29Issue(1)：66-69,4.DOI:10.3969/j.issn.1673-5293.2018.01.017
孕前超重/肥胖孕妇妊娠期糖尿病发病的危险因素研究
Risk factors of gestational diabetes mellitus in pregnant women with pre-pregnancy overweight/obesity
摘要
Abstract
Objective To discuss the risk factors of gestational diabetes mellitus(GDM)in pregnant women with pre-pregnancy overweight/obesity.Methods The nested case-control study was adopted.According to inclusion and exclusion criteria standard,the pregnant women registered in outpatients service of the department of obstetrics and gynecology in Beijing Friendship Hospital during September 2014 to March 2015 were selected as research objects.The complete medical history of pregnant women (including age,pre-pregnancy body mass,body weight in oral glucose tolerance test,history of pregnancy,etc.)were recorded. And 5 ml fasting blood sample was collected to test the levels of blood lipid,serum C-reactive protein,insulin,blood sugar and leptin.Results In this study,there were 119 cases completing follow-up,including 37 cases of GDM with incidence of 31.09%(37/119).In univariate analysis,there were significant differences in pre-pregnancy body mass index,serum fasting blood glucose, fasting insulin,insulin resistance index,ratio of CRP>8mg/L,and level of leptin between GDM group and normal group(t/χ2 value was 2.330,4.826,6.484,6.724,7.119 and 3.782,respectively,all P<0.05).There was no significant difference in the age of pregnant women,registered gestational weeks,weight gain in the second trimester of pregnancy,whether primipara,family history of diabetes,and blood lipid levels(cholesterol,triglycerides,high density,low density)between two groups(t/χ2value was 1.176,1.629,1.280,0.076,0.193,1.822,1.433,0.010 and 2.164,respectively,all P>0.05).Logistic regression analysis showed that insulin resistance index[OR:13.27,95% CI(3.98-44.18)],CRP>8mg/L[OR:4.35,95% CI(0.97-19.64)],and leptin level[OR:1.52,95% CI(1.11-2.08)]were the risk factors of GDM in pregnant women with pre-pregnancy overweight/obesity.Conclusion The incidence of GDM in pregnant women with pre-pregnancy overweight/obesity is high,and risk factors are insulin resistance in the first trimester of pregnancy,high CRP and high leptin level.Therefore,for the pregnant women with pre-pregnancy overweight/obesity,it is necessary to detect relevant indicators in early pregnancy and give interventions to reduce the incidence of GDM.关键词
超重/肥胖/妊娠期糖尿病/胰岛素抵抗/C反应蛋白/瘦素Key words
overweight/obesity/gestational diabetes mellitus(GDM)/insulin resistance(IR)/C-reaction protein(CRP)/leptin分类
医药卫生引用本文复制引用
丁冰杰,余焕玲,王佳,毕研霞,洪忠新..孕前超重/肥胖孕妇妊娠期糖尿病发病的危险因素研究[J].中国妇幼健康研究,2018,29(1):66-69,4.基金项目
国家自然科学基金资助项目(81273070) （81273070）
首都医科大学附属北京友谊医院启动基金资助项目(YYQDKT2014-21) （YYQDKT2014-21）
