现代妇产科进展2025，Vol.34Issue(11)：808-813,6.DOI:10.13283/j.cnki.xdfckjz.2025.11.001
孕早期体重特征、脂代谢及血清5-羟色胺水平对妊娠期糖尿病发生风险的预测价值
Predictive value of weight characteristics,lipid metabolism,and serum 5-hydroxytryptamine level in the first trimester of pregnancy for the risk of gestational diabetes mellitus
摘要
Abstract
Objective:To explore the predictive value of weight characteristics,lipid metabolism,and serum 5-hydroxytryptamine(5-HT)level in the first trimester of pregnancy for the risk of gestational diabetes mellitus(GDM).Methods:This was a prospective observational study.A total of 251 pregnant women who underwent prenatal examinations at the Outpatient Department of Obstetrics,First Affiliated Hospital of Qiannan Medical College from June 2023 to June 2024 were selected as the research subjects.According to the occurrence of GDM,they were divided into the GDM group and the non-GDM group.The general clinical data,weight-re-lated characteristics in the first trimester of pregnancy,indicators of glucose and lipid metabo-lism,and 5-HT characteristics were compared between the two groups of pregnant women.The factors with P<0.05 in the univariate analysis were included in the multivariate logistic regres-sion analysis to screen the independent influencing factors related to the risk of GDM in preg-nant women.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive value of the combined influencing factors for the risk of GDM in pregnant women.Results:All 251 pregnant women included in the study completed the prenatal examinations and follow-up.During the follow-up period,38 pregnant women developed GDM,with an incidence rate of 15.1%(38/251).The age,number of daily meals,proportion of smoking history,weight in the first trimester of pregnancy,body mass index(BMI),weight gain rate,fasting blood glucose(FBG),glycated hemoglobin(HbA1c),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and homeostasis model assessment of insulin resistance index(HOMA-IR)levels of pregnant women in the GDM group were higher than those in the non-GDM group,while the daily exercise amount,pancreatic islet β-cell secretion index(HOMA-β),and 5-HT level were lower than those in the non-GDM group(P<0.05).The results of multivariate logistic regression analysis showed that age(OR=1.179,95%CI:1.015～1.369,P=0.031),BMI in the first trimester of pregnancy(OR=1.568,95%CI:1.007～2.442,P=0.047),weight gain rate(OR=2.030,95%CI:1.565～4.249,P=0.003),HbA1c(OR=2.525,95%CI:1.043～6.108,P=0.040),HOMA-β(OR=0.878,95%CI:0.787～0.979,P=0.019),and 5-HT(OR=0.905,95%CI:0.845～0.969,P=0.004)were all independent influencing factors for GDM in pregnant women.The ROC analysis showed that the AUC of the combined prediction model constructed based on the above six indicators for predicting the risk of GDM in pregnant women was 0.808(95%CI:0.732～0.884),which was higher than the independent predictive efficiency of each influen-cing factor.At this time,the sensitivity of the model was 0.884,and the specificity was 0.896.Conclusion:The combined application of the age of pregnant women,BMI in the first trimester of pregnancy,weight gain rate,HbA1c,HOMA-β,and 5-HT level can effectively predict the risk of GDM.关键词
体重/脂代谢/5-羟色胺/妊娠期糖尿病/预测模型Key words
Weight/Lipid metabolism/5-Hydroxytryptamine/Gestational diabetes mel-litus/Prediction model分类
医药卫生引用本文复制引用
姚瑞,张毅娟,张华,朱焱..孕早期体重特征、脂代谢及血清5-羟色胺水平对妊娠期糖尿病发生风险的预测价值[J].现代妇产科进展,2025,34(11):808-813,6.基金项目
贵州省卫生健康委科学技术基金项目(No:gzwkj2023-279) （No:gzwkj2023-279）
