生殖医学杂志2025，Vol.34Issue(11)：1466-1473,8.DOI:10.3969/j.issn.1004-3845.2025.11.003
孕早期残余胆固醇水平与妊娠期糖尿病孕妇新生儿出生体重的关系研究
Study on the relationship between remnant cholesterol level in early pregnancy and birth weight of newborns in pregnant women with gestational diabetes
摘要
Abstract
Objectives:To explore the relationship between remnant cholesterol(RC)level in early pregnancy and birth weight of newborns in pregnant women with gestational diabetes mellitus(GDM). Methods:A total of 420 pregnant women with GDM(GDM group)and 210 healthy pregnant women undergoing prenatal examinations(the control group)at The Second Affiliated Hospital of Xi'an Jiaotong University from January 2021 to December 2023 were selected as the research subjects.Blood lipid level of fasting venous blood was measured and RC level was calculated.The GDM pregnant women were divided into T1 group(RC＜0.37 mmol/L,143 cases),T2 group(0.37≤RC≤0.75 mmol/L,140 cases)and T3 group(RC＞0.75 mmol/L,137 cases)according to the third quartile of serum RC levels.Multivariate logistic regression and restricted cubic spline analyses were used to examine the association of early pregnancy RC levels with both large-for-gestational-age infant and macrosomia in GDM pregnant women.Receiver operating characteristic(ROC)curve was used to assess the predictive value of early pregnancy RC level for large-for-gestational-age infant and macrosomia in GDM pregnant women. Results:The levels of total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL C),RC,and the proportion of large-for-gestational-age infants and macrosomia in the GDM group were significantly higher than those in the control group(P＜0.05),while the high-density lipoprotein cholesterol(HDL-C)level was significantly lower than that in the control group(P＜0.05).After the GDM pregnant women were divided into T1 group,T2 group and T3 group according to the third quartile of serum RC levels,there were significant differences in preconception body mass index(BMI),the levels of fasting blood glucose(FPG),the Homeostasis Model Assessment of Insulin Resistance(HOMA-IR),TC,TG,LDL-C,RC,HDL-C as well as the proportion of large-for-gestational-age infants and macrosomia among the three groups when compared pairwise(P＜0.05).Multivariate logistic regression analysis showed that the elevated RC level was an independent risk factor for the occurrence of large-for-gestational-age infant and macrosomia in GDM pregnant women,and T2 and T3 had a higher risk for the occurrence of large-for-gestational-age infant and macrosomia when compared with T1(P＜0.05).Restricted cubic spline plot display,after adjusting for age,preconception BMI,educational level,monthly family income,parity and the levels of FPG,fasting insulin(FINS),HOMA-IR,TC,TG,HDL-C,LDL-C,there were positive dose-response relationships of early pregnancy RC level with the proportion of both large-for-gestational-age infants and macrosomia in GDM pregnant women(nonlinear P＜0.05).The ROC curve showed that when the RC level in early pregnancy was 0.53 mmol/L,the predicted area under the curve for large-for-gestational-age infant and macrosomia in GDM pregnant women was 0.779 and 0.783 respectively. Conclusions:Elevated early pregnancy RC level is positively correlated with an increased risk of large-for-gestational-age infant and macrosomia in GDM pregnant women,and it has certain predictive value for the occurrence of large-for-gestational-age infant and macrosomia in GDM pregnant women.关键词
妊娠期糖尿病/孕早期/残余胆固醇/大于胎龄儿/巨大儿Key words
Gestational diabetes mellitus/Early pregnancy/Remnant cholesterol/Large-for-gestational-age infant/Macrosomia分类
医药卫生引用本文复制引用
唱一男,王莉,张华,汪倩倩,梁翼飞,王惠萍..孕早期残余胆固醇水平与妊娠期糖尿病孕妇新生儿出生体重的关系研究[J].生殖医学杂志,2025,34(11):1466-1473,8.基金项目
陕西省2021年科技计划项目(2021SF-251) （2021SF-251）
