中国全科医学2024，Vol.27Issue(29)：3602-3607,3615,7.DOI:10.12114/j.issn.1007-9572.2024.0023
孕前正常BMI孕妇孕早期体成分与妊娠期糖尿病关系的研究
The Relationship between Body Composition in Early Pregnancy and Gestational Diabetes Mellitus in a Population of Normal BMI Pregnant Women
摘要
Abstract
Background Gestational diabetes mellitus(GDM)is closely related to the short-term and long-term health outcomes of the mothers and offspring.Pre-pregnancy BMI is strongly associated with GDM,nevertheless,it does not distinguish between body fat content and fat distribution.Only using it to assess obesity is flawed.Normal weight obesity(normal BMI but body fat percentage above 30%)and normal weight with central obesity(normal BMI but visceral fat area above 80 cm2)show different degree of metabolic dysregulation.However,those population are usually overlooked in clinical practice and there is a paucity of research on those population and GDM.Objective To explore the correlation between body composition in early pregnancy and GDM in a population of normal pre-pregnancy BMI,and to investigate the relationship between fat distribution and GDM.Methods We performed a study that included 1 938 singleton pregnant women registered in the obstetric out-patient clinic of Beijing Obstetrics and Gynecology Hospital,Capital Medical University from October 2018 to October 2022.They voluntarily underwent nutritional assessment in early pregnancy and had regular pregnancy check-ups until 24-28 weeks of gestation,who underwent body composition testing in early pregnancy(6-16 weeks)and oral glucose tolerance test(OGTT)at 24-28 weeks.According to the OGTT results,the study population were divided into the GDM group(n=382)and the normal group(n=1 556).We estimated the relationship between body composition and fat distribution with GDM in early pregnancy with binary Logistic regression.Results Body fat mass(BFM),visceral fat area(VFA),percentage body fat(PBF),and fat mass index(FMI)in the GDM group were higher than in the normal group(P<0.05).BFM,VFA,PBF,FMI(OR=1.044,95%CI=1.012-1.078;OR=1.007,95%CI=1.002-1.012;OR=1.041,95%CI=1.012-1.070;OR=1.138,95%CI=1.043-1.241)(P<0.05)and central obesity(VFA≥80 cm2)(OR=1.396,95%CI=1.101-1.770,P<0.05)associated with a significant increased risk for GDM with binary Logistic regression analysis.Spearman rank correlation analysis showed that BFM,VFA,PBF,FMI and blood glucose of the OGTT test were positively correlated(P<0.05).Conclusion Among normal pre-pregnancy BMI women,BFM,VFA,PBF,and FMI in early pregnancy were the risk factors of GDM.Central obesity(VFA≥80 cm2)could independently predict the development of GDM.It is necessary to pay attention to fat distribution during pregnancy check-ups and to strengthen the pregnancy management for central obesity women.关键词
妊娠期糖尿病/妊娠初期/体成分/体脂百分比/内脏脂肪面积/中心性肥胖/影响因素分析Key words
Gestational diabetes mellitus/Pregnancy trimester,first/Body composition/Percentage of body fat/Visceral fat area/Central obesity/Root cause analysis分类
医药卫生引用本文复制引用
徐丽丽,郑薇,袁仙仙,马恺文,张浦杨,李光辉..孕前正常BMI孕妇孕早期体成分与妊娠期糖尿病关系的研究[J].中国全科医学,2024,27(29):3602-3607,3615,7.基金项目
国家自然科学基金资助项目(82301916,82171671) （82301916,82171671）
北京市卫生健康委员会高层次公共卫生技术人才建设项目培养计划(领军人才-02-02) （领军人才-02-02）
