单纯糖筛查异常孕妇血脂与新生儿出生体重的关系  

Relationship between maternal serum lipid levels and newborn weight in pregnant women with single positive diabetic screening test

作　　者：金红梅[1] 杨永彬[2] 徐先明[2] 

机构地区：[1]复旦大学附属中山医院青浦分院妇产科,上海201700 [2]上海市第一人民医院妇产科,200080

出　　处：《中国医师进修杂志》2011年第9期17-20,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的了解单纯糖筛查异常孕妇的血脂水平及其与新生儿出生体重的关系。方法孕龄24～28周、糖筛查异常孕妇406例，行口服75g葡萄糖耐量试验（OGTT），其中妊娠期糖尿病（GDM）115例（GDM组），妊娠期糖耐量减低（GIGT）60例（GIGT组），单纯糖筛查异常231例（单纯糖筛查异常组）。测定并比较三组孕妇的总胆固醇（TC）、三酰甘油（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（Apo）A1和ApoB。结果GDM组TG明显高于GIGT组和单纯糖筛查异常组（P〈0．01），HDL—C、ApoB明显低于GIGT组和单纯糖筛查异常组（P〈0．01）。单纯糖筛查异常组高TG孕妇的巨大儿发生率（25．0％，11／44）高于血脂正常孕妇（11．2％，21／187）（P=0．017）。多元线性回归分析发现，TG与ApoB是新生儿出生体重的独立危险因素（F=7．677，P=0．006；F=7．842，P=0．001）。结论空腹血清TG和ApoB是糖筛查异常但糖耐量试验正常孕妇新生儿出生体重的独立危险因素。Objective To investigate the relationship between maternal serum lipid levels and newborn weight in pregnant women with single positive diabetic screening test. Methods On the basis of 75 g oral glucose tolerance test （OGTY）, 406 pregnant women during 24-28 gestational week whose 50 glucose challenge test （GCT）≥ 7.8 mmol/L were separated to gestafional diabetes mellitus （GDM） group with 115 cases, gestational impaired glucose tolerant （GIGT） group with 60 cases, and GCT （＋） group with 231 cases. The serum levels of total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol（ LDL-C ）, apolipoprotein A1 （ApoA 1 ） and apolipoprotein B （ ApoB ） were measured at the same time. Results Serum TG concentration was significantly higher in GDM group than that in GIGT group and GCT（＋ ） group（P 〈 0.01 ）. The level of FIDL-C, ApoB in GDM group were lower than those in GIGT group and GCT （＋） group （P〈 0.01 ）. In the 231 women with positive diabetic screening but normal glucose tolerance who delivered at term, the incidence of macrosomia was significantly higher in those with TG levels higher than 3.5 mmol/L （25.0%, 11/44） than in mothers who TG levels were lower than 3.5 mmol/L （ 11.2%, 21/187 ） （P = 0.017 ）. Multiple regression analysis （ stepwise ） showed that the independent risk factors of macrosomia was the level of TG and ApoB （F = 7.677,P = 0.006;F = 7.842,P = 0.001 ）. Conclusion Among pregnant women with single positive diabetic screening test,maternal serum TG and ApoB are independently associated with neonatal birth weight.

关 键 词：糖尿病 妊娠 葡萄糖代谢障碍 脂代谢障碍 出生体重 

分 类 号：R714[医药卫生—妇产科学]