孕16～20周骨钙素水平对妊娠期糖尿病影响的巢氏病例对照研究  

Influence of maternal serum osteocalcin levels at 16-20 weeks of gestation on gestational diabetes mellitus: a nested case-control study

作　　者：冯佩[1] 牛晓虎[1] 许锬[2] FENG Pei;NIU Xiao-hu;XU Tan(Kunshan Maternal and Child Health Care Institute,Kunshan,Jiangsu 215300,China;School of Public Health of Medical College,Suzhou University,Suzhou ,Jiangsu 215123,China)

机构地区：[1]昆山市妇幼保健所,江苏昆山215300 [2]苏州大学医学部公共卫生学院,江苏苏州215123

出　　处：《实用预防医学》2019年第2期160-162,共3页Practical Preventive Medicine

基　　金：苏州市"科教兴卫"青年科技项目(KJXW2014051)

摘　　要：目的探究孕16～20周骨钙素水平对妊娠期糖尿病的影响,为妊娠期糖尿病的预防提供相应的对策与措施。方法本研究采用巢氏病例对照研究,通过孕24周的75 g葡萄糖耐量试验结果选取病例组(妊娠期糖尿病组)和对照组(血糖正常组),回顾性的收集研究对象的基础信息及孕16～20周的血液标本,并进行血清骨钙素的检测。采用非条件logistic回归分析孕16～20周骨钙素水平对妊娠期糖尿病的影响。结果妊娠期糖尿病组的16～20周骨钙素水平高于血糖正常组,进一步分析发现,调整了年龄、孕早期体质指数、舒张压等变量后,骨钙素水平第3、4分位(8～9 ng/ml,≥9 ng/ml)均增加妊娠期糖尿病的发生风险,OR (95%CI)分别为3. 13(1. 20～8. 14),4. 01(1. 42～11. 32),且随着骨钙素水平的升高,妊娠期糖尿病发生的危险性逐渐升高(χ2趋势=8. 99,P=0. 003)。结论孕16～20周骨钙素水平的升高可增加妊娠期糖尿病发生风险。Objective To explore the impact of maternal serum osteocalcin levels at 16-20 weeks of gestation on gestational diabetes mellitus(GDM),and to provide corresponding countermeasures for prevention of GDM. Methods A nested case-control study was conducted in pregnant women undergoing 75 g glucose tolerance test at 16-20 gestational weeks,and then all the subjects were divided into the GDM group and the normal control group according to the test results. All the subjects’ general information and blood specimens at 16-20 gestational weeks were retrospectively collected,and then maternal serum osteocalcin levels were determined. Unconditioned logistic regression analysis was used to analyze the impact of maternal serum osteocalcin levels at16-20 gestational weeks on gestational diabetes. Results Maternal serum osteocalcin levels at 16-20 gestational weeks were higher in the GDM group than in the normal control group. Further analysis revealed that after adjusting for age,early pregnancy body mass index(BMI),diastolic blood pressure and other variables,the osteocalcin levels in the third(8-9 ng/ml) and fourth quartiles(≥9 ng/ml) could increase the risk of occurrence of GDM,and OR(95% CI) were 3.13(1.20-8.14) and 4.01(1.42-11.32) respectively. The higher the maternal serum osteocalcin level,the higher the risk for developing GDM(χ^2tendency= 8.99,P =0.003). Conclusions The increment of maternal serum osteocalcin levels at 16-20 gestational weeks can increase the risk for developing GDM.

关 键 词：骨钙素 妊娠期糖尿病 巢氏病例对照研究 

分 类 号：R714.256[医药卫生—妇产科学]