早孕期体成分与妊娠期糖尿病的关系  

Relationship between maternal body composition in first trimester and gestational diabetes mellitus

作　　者：王燕侠[1] 王文玲[2] 李芳[3] 周敏[2] 毛宝宏[1] 孟照琰[2] Wang Yanxia;Wang Wenling;Li Fang;Zhou Min;Mao Baohong;Meng Zhaoyan(Research Center, Gansu Provincial Maternity and Children Health Care Hospital, Lanzhou 730050, China;Perinatal Medicine Center, Gansu Provincial Maternity and Children Health Care Hospital, Lanzhou 730050, China;Department of Integrated Chinese and Western Medicine Gynecology, Gansu Provincial Maternity and Children Health Care Hospital, Lanzhou 730050, China)

机构地区：[1]甘肃省妇幼保健院科研中心,兰州730050 [2]甘肃省妇幼保健院围产医学中心,兰州730050 [3]甘肃省妇幼保健院中西医结合妇科,兰州730050

出　　处：《中华围产医学杂志》2019年第4期261-264,共4页Chinese Journal of Perinatal Medicine

基　　金：中国疾病预防控制中心妇幼中心合生元母婴营养与健康研究项目(2018FYH007);甘肃省科技重点研发专项(17YF1FA108);甘肃省卫生行业科研计划(GSWSKY2016-47);兰州市科技计划项目(2015-2-35).

摘　　要：目的探讨早孕期体成分与妊娠期糖尿病(gestational diabetes mellitus, GDM)的关系。 方法运用基于前瞻性队列研究的巢式病例对照研究方法,于2016年7月至2017年1月,选取于甘肃省妇幼保健院产前检查且自愿接受营养评价的孕8~14周孕妇,记录体重指数,通过生物电阻抗法分析母体体成分(体脂重、去脂体重与体脂百分比),追访妊娠结局。共选取70例确诊GDM的孕妇作为GDM组,以年龄及孕前体重指数为匹配条件,按1∶2匹配,纳入140例健康孕妇作为对照组。通过χ^2检验及多因素logistic回归分析2组孕妇体成分的差异及其与GDM的关系。 结果早孕期体重指数≥30 kg/m^2(OR=1.973,95%CI:1.095~7.664,P=0.024)以及体脂百分比≥30%(OR=1.261,95%CI:1.021~2.982,P=0.010)、≥35%(OR=4.020,95%CI:1.341~7.950,P<0.001)和≥40%(OR=8.311,95%CI:5.018~42.771,P<0.001)是GDM的危险因素。 结论早孕期体重指数≥30 kg/m2和体脂百分比≥30%是GDM发病的危险因素,早孕期过度的脂肪组织可能在GDM的发生发展中起重要作用。ObjectiveTo investigate the relationship between maternal body composition in first trimester and gestational diabetes mellitus (GDM). MethodsIn this nested case-control study based on a prospective cohort study, we enrolled gravidas between 8 and 14 weeks of gestation, who received prenatal care and voluntary nutrition evaluation in Gansu Provincial Maternity and Children Health Care Hospital, from July 2016 to January 2017. Body mass index (BMI) of each gravida was recorded and the maternal body composition including body fat, body fat percentage and fat-free mass was measured by bioelectrical impedance analysis. Pregnancy outcomes were followed up. A total of 70 patients diagnosed with GDM were allocated to the GDM group and 140 healthy gravidas matching for age and pre-pregnancy BMI were selected as the control group. Differences in body composition between two groups and their relationships with GDM were analyzed by Chi-square test and multivariate logistic regression. ResultsMaternal BMI≥30 kg/m2 (OR=1.973, 95%CI: 1.095-7.664, P=0.024) and body fat percentage≥30%,≥35% and ≥40% in first trimester (OR=1.261, 95%CI: 1.021-2.982, P=0.010;OR=4.020, 95%CI: 1.341-7.950, P<0.001;OR=8.311, 95%CI: 5.018-42.771, P<0.001) were the risk factors of GDM. ConclusionsBMI≥30 kg/m2 and body fat percentage ≥30% in first trimester are risk factors for GDM and excessive adipose tissue may play an important role in the development of GDM.

关 键 词：妊娠初期 人体质量指数 糖尿病 妊娠 危险因素 

分 类 号：R714.256[医药卫生—妇产科学]