妊娠糖尿病/妊娠糖耐量低减患者孕晚期血脂特点及其与体重的关系  

Blood-lipid profile of pregnant women with gestational diabetes or impaired glucose tolerance during late pregnancy and its relation with maternal body weight

作　　者：刘燕萍[1] 李宁[1] 陈伟[1] 李杰[2] 刘鹏举[1] 刘莉[1] 

机构地区：[1]中国医学科学院北京协和医院营养科,北京100730 [2]中国医学科学院北京协和医院病案室

出　　处：《解放军医学杂志》2008年第5期595-597,共3页Medical Journal of Chinese People's Liberation Army

基　　金：中国医学科学院北京协和医院重点课题资助项目(07M00357)

摘　　要：目的了解妊娠糖尿病/妊娠糖耐量低减（GDM/GIGT）患者妊娠晚期血脂变化及其与孕期体重变化的关系。方法100g葡萄糖口服糖耐量试验（OGTT）筛查,按照美国糖尿病学会（ADA）标准诊断为GDM/GIGT的孕晚期初产妇女（n=216,年龄32.08±3.85岁）。记录孕前、分娩前体重,测量身高,计算孕前体质指数（BMI）、孕期增重、孕期体重增幅。于孕29±1周采空腹静脉血测定血浆总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）、脂蛋白a[Lipoprotein a,Lp（a）]。根据孕期体重增长将患者分为低于正常（〈10.0kg）组、正常（10~12.5kg）组和高于正常（〉12.5kg）组,分析各组间血脂指标的差异;根据孕前BMI将患者分为正常（18.5~23.0）组,消瘦（〈18.5）组、超重（23.1-25.0）组和肥胖（〉25）组,分析各组间血脂指标的差异;分析孕前BMI、孕期增重、孕期体重增幅与孕晚期血脂的相关性。结果除Lp（a）外,TC、TG、HDL-c、LDL-c、ApoA1、ApoB的均值高于正常上限。多数GDM/GIGT患者孕前BMI处于正常范围,而孕期增重过高。孕前BMI各组,孕期增重各组间各血脂指标的水平没有统计学差异,且孕前BMI、孕期增重、孕期体重增幅与各血脂指标没有明显相关性。结论初步证实GDM/GIGT患者存在与正常妊娠相似的孕晚期血脂升高现象,这种变化与孕前的BMI或孕期的体重变化无显著相关性。Objective To determine the blood-lipid profile of pregnant women with gestational diabetes （GDM） or gestational impaired glucose tolerance （GIGT） during late pregnancy, and to survey the relationship between maternal lipid levels in the third-trimester and the increase in maternal body weight. Methods Two hundred and sixteen first pregnant women （mean age 32.08±3.85Y） with GDM/GIGT in late pregnancy, diagnosed by 100g OGTT ADA standard, were included in the present study. Serum total cholesterol （TC）, triglycerides （TG）, HDL-c, LDL-c, ApoA1, ApoB and Lp （a） were determined in their early third-trimester. The height and body weight were measured before delivery. The pre-pregnancy body weight was given by the patients themselves. The patients were divided into 4 groups according to their pre-pregnancy body mass index （BMI, 〈18.5 underweight, 18.5-23.0 normal, 23.0-25.0 overweight, 〉25.0 obesity）. The bodyweight gain during pregnancy was the second basis of categorization （〈10.0kg inadequate, 10.0-12.5kg normal, 〉12.5kg excessive）. SNK-q test was performed to compare the lipid indicators mentioned above between the four BMI groups or between the three bodyweight gain groups. Results Universal and significant increase of HDL-c, ApoA1 and TG levels in GDM/GIGT women were observed during the third-trimester of pregnancy, and the increase of TC, LDL-c and ApoB were slight compared to normal range. More than a half of patients had normal BMI （18.5-23.0kg/m2） before pregnancy. The average bodyweight gain was 16.0±5.0kg, excessive body weight gain was observed in 74% GDM/GIGT patients, while inadequate body weight gain was only observed in 4% patients. There was no significant difference of serum lipid levels between different groups of pre-pregnant BMI or bodyweight gain. No obvious relations existed between either pre-pregnant BMI or body weight gain to serum lipid levels. Conclusions In present study, the serum lipid profile in GDM/GIGT women is similar to that of normal ges

关 键 词：糖尿病 妊娠 葡糖耐受不良 脂蛋白类 人体质量指数 

分 类 号：R714.148[医药卫生—妇产科学]