孕中期血清胆红素与妊娠期糖尿病的相关性研究  

Correlation between serum bilirubin and gestational diabetes mellitus during mid-pregnancy

作　　者：孔曼[1] 罗振钊[1] 卢忠心[1] 曹小淬 张红梅[1] 

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院检验科,武汉430014

出　　处：《公共卫生与预防医学》2017年第4期70-72,共3页Journal of Public Health and Preventive Medicine

摘　　要：目的探讨孕期中胆红素与妊娠期糖尿病(GDM)的相关性。方法以来自在华中科技大学附属武汉市中心医院进行产检和分娩的孕妇为研究对象,对其采用回顾性研究获得基本信息,采用钒酸盐氧化法测定血清中总胆红素(TB)、直接胆红素(DB),采用酶法测定空腹血糖(GLU)的水平,采用免疫比浊法测定c-反应蛋白(CRP)和白蛋白(Alb)。结果 GDM的发病率为7.86%(102/1 297)。TB、DB在GDM组的值要低于非GDM组(5.8±2.2和6.4±2.4,P=0.023;2.4±1.3和2.5±0.9,P=0.036)。进一步采用线性回归分析的方法分析TB、DB与空腹血糖、1h血糖、2h血糖间的线性关系,TB、DB与血糖值呈负相关。Logistic回归分析TB、DB与GDM的相关性,其最高层与最低层相比患GDM的风险降低(RR 0.54;95%CI,0.31~0.95)和(RR 0.61;95%CI,0.38~0.99)。结论妊娠中期高胆红素水平患GDM的风险性降低。Objective To explore the correlation between bilirubin concentrations and gestational diabetes mellitus（ GDM） during mid-pregnancy. Methods The pregnant women were collected from the Central Hospital of Wuhan,Huazhong University of Science and Technology,the basic data were obtained through retrospective study. Vanadate oxidation method was used to test total bilirubin（ TB） and direct bilirubin（ DB）,enzymatic method was used to test fasting GLU. Immune turbidimetry was used to test CRP and Alb.Results The morbidity of GDM was 7. 86%（ 102/1 297）. The mean of total bilirubin and direct bilirubin in GDM were lower in non-GDM（ 5. 8 ± 2. 2 and 6. 4 ± 2. 4,P = 0. 023; 2. 4 ± 1. 3 and 2. 5 ± 0. 9,P = 0. 036）. Two-piecewise linear regression analysis was further adopted to assess the correlation between total bilirubin、direct bilirubin and fasting glucose、1h blood glucose、2h blood glucose.In multiple logistic regression analysis,the relative risk（ RR） of developing GDM was lower in the highest layer of the total bilirubin and direct bilirubin levels than that in the lowest layer（ RR 0. 54; 95% CI,0. 31-0. 95） and（ RR 0. 61; 95% CI,0. 38-0. 99）.Conclusion The results suggested that pregnant women with higher serum bilirubin had lower risk for the development of GDM during mid-pregnancy.

关 键 词：总胆红素 直接胆红素 妊娠期糖尿病 

分 类 号：R17[医药卫生—妇幼卫生保健] R587.1[医药卫生—公共卫生与预防医学]