孕早期脂代谢异常对妊娠期糖尿病发病率的影响  

Effects of Abnormal Lipid Metabolismin of Early Pregnancy on the Incidence Rate of Gestational Diabetes Mellitus

作　　者：陶旻枫[1] 王小榕[1] 

机构地区：[1]首都医科大学附属北京妇产医院妇幼保健院,北京100026

出　　处：《医学临床研究》2017年第6期1054-1057,共4页Journal of Clinical Research

基　　金：中国疾病预防控制中心妇幼保健中心合生元母婴营养与健康研究项目（编号：2015FY004）

摘　　要：【目的】孕早期脂代谢异常对妊娠期糖尿病（GDM）发病率的影响。【方法】选取120例孕早期脂代谢异常的孕妇为观察组，另选120例孕早期脂代谢正常的孕妇为对照组。检测两组血清脂代谢指标：胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）以及脂肪细胞因子：瘦素、游离脂肪酸；血糖及胰岛素抵抗指标：空腹血糖（FBG）、糖化血红蛋白（HbAlc）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）水平。分析TG、瘦素与血糖及胰岛素抵抗指标的相关性，并统计两组GDM发生率、妊娠结局、胎儿及相关并发症发生情况。【结果】观察组孕妇TG、TC、LDL-C、瘦素、游离脂肪酸水平明显高于对照组，HDL-C水平明显低于对照组（P〈O．05）；观察组血糖指标FBG、HbAlc、HOMA-IR高于对照组，胰岛素抵抗指标FINS低于对照组（P〈0．05）。单N素相关分析显示TG、瘦素水平均与FBG、HbAlc、HO-MA-IR呈正相关，与FINS呈负相关（P〈0．05）。观察组GDM发生率为35．00％，显著高于对照组16．67％（P〈O．05）；与对照组相比，观察组剖宫产率明显增高（P〈0．05），观察组分娩后胎儿窘迫、巨大儿发生率明显增高（P〈0．05）。【结论】孕早期脂代谢异常即血脂、脂肪细胞因子水平明显异常可显著增加GDM发生率，并影响孕妇妊娠结局和胎儿出生情况。[Objective]To explore the effects of abnormal lipid metabolism in early pregnancy on the inci- dence rate of gestational diabetes mellitus （GDM）.[Methods]A total of 120 pregnant women with abnormal lipid metabolism in the early pregnancy were selected as the observation group, and other 120 pregnant women with normal lipid metabolism in the early pregnancy were selected as the control group. The levels of serum lipid metabolism indexes cholesterol（TC）, triglyceride （TG）, low density lipoprotein cholesterol（LDL-C）, high density lipoprotein cholesterol （HDL-C）, adipoeytokine leptin, free fatty acid, blood glucose and insulin resistance indexes fasting blood glucose （FBG）, glyeosylated hemoglobin （HbAlc）, fasting membrane insulin （FINS）, insulin resistance index （HOMA-IR） were measured in the two groups. The correlation of TG, leptin and blood glucose and insulin resistance indexes was analyzed, and the incidence rate of GDM, pregnancy out come, fetal and related complications were analyzed in two groups.[Results]Compared with the control group, the levels of TG, TC and LDL-C in the observation group were significantly higher while the level of HDL C was significantly lower （ P 〈0.05）, and leptin and free fatty acid were significantly higher （ P 〈0.01）. At the same time, the levels of blood glucose indexes FBG, HbAlc and HOMA-IR were significantly higher in the observation group, and the insulin resistance index FINS was significantly lower （ P 〈0.01）. Univariate cor- relation analysis showed that the levels of TG and leptin were positively correlated with FBG, HbAIc and HO- MA IR, but negatively correlated with FINS （ P 〈0.05）. The incidence rate of GDM was 35% in the observa- tion group, which was significantly higher than that in the control group with16.67% （ P 〈0.05）. Com- pared with the control group, the spontaneous labor rate of the observation group was significantly lower, and the cesarean section rate was significantly higher （ P 〈0.05�

关 键 词：妊娠初期 脂代谢障碍 糖尿病 妊娠 发病率 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]