妊娠期糖尿病患者不同孕期脂代谢及巨大儿发生  

Study of lipid metabolism of pregnant women with gestational diabetes mellitus during different gestatinal weeks and its correlation with the rate of macrosomia

作　　者：王润秋 桑琳[1] 杜世华[1] WANG Runqiu;SANG Lin;DU Shihua(The Second People's Hospital of Hefei,Anhui Province,230011)

机构地区：[1]安徽省合肥市第二人民医院

出　　处：《中国计划生育学杂志》2020年第2期251-256,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨妊娠期糖尿病(GDM)患者不同孕期脂代谢指标变化及与巨大儿发生关系。方法:回顾性收集2017年1月-2018年6月本院收治的GDM患者200例临床资料(GDM组),同期糖耐量正常的健康孕妇200例为对照组,GDM组根据新生儿结局分为巨大儿组与非巨大儿组。比较各组孕妇孕早、中、晚期血总胆固醇(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)、载脂蛋白A1(Apo-A1)、载脂蛋白(Apo-B)水平。结果:GDM组孕早、中、晚期TC、TG、LDL-C、Apo-B均高于对照组,而HDL-C和Apo-A1均低于对照组(均P<0.05);分娩巨大儿孕妇在孕早、中、晚期TC、TG、LDL-C、Apo-B水平均高于非巨大儿孕妇,而HDL-C和Apo-A1低于非巨大儿孕妇(P<0.05)。TC、TG、LDL-C、Apo-B均与巨大儿发生呈正相关,而HDL-C、Apo-A1与巨大儿发生呈负相关(P<0.05)。logistic回归分析显示,孕期体重增长、血糖控制不良、孕期TG是发生巨大儿的独立危险因素,孕期HDL-C、Aop-A1是避免发生巨大儿的保护因素,孕早期和晚期TC、LDL-C是发生巨大儿的危险因素(均P<0.05)。结论:GDM患者孕期存在不同程度的脂代谢紊乱,紊乱可能增加了分娩巨大儿风险。Objective:To investigate the change of lipid metabolism indexes of pregnant women with gestational diabetes mellitus(GDM)during different gestatinal weeks,and to study its correlation with the rate of macrosomia.Methods:The clinical data of 200 women with GDM from January 2017 to June 2018 were retrospectively analyzed,and they were included in study group,and further divided into group A(women with macrosomia)and group B(women without macrosomia).Another 200 healthy pregnant women with normal glucose tolerance(NGT)were in control group during the same time.The levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),Apolipoprotein A1(Apo-A1),apolipoprotein(Apo-B)of women were detected and compared among these groups.Results:The levels of TC,TG,LDL-C,Apo-B of women during the first,second and third trimester of pregnancy in the study group were significant higher than those of women in the control group,but the levels of HDL-C and Apo-A1 of women in the study group were significant lower(P<0.05).The levels of TC,TG,LDL-C,Apo-B of women with macrosomia during the first,second and third trimester of pregnancy in group A were significant higher than those of women in group B,but the levels of HDL-C and Apo-A1 of women in group A were significant lower(P<0.05).The levels of TC,TG,LDL-C,Apo-B of women were significantly positively correlated with rate of macrosomia,while the levels of HDL-C and Apo-A1 were significantly negatively correlated with rate of macrosomia(P<0.05).Logistic regression analysis showed that,gain of weight(GWG),poor glycemic control,and TG level of women during the pregnancy were independent risk factors of macrosomia(P<0.05),but HDL-C and Aop-A1 levels were protective factors of avoiding macrosomia(P<0.05).Conclusion:Pregnant women with GDM have different degrees of lipid metabolism disorder,which will increase the risk of macrosomia.

关 键 词：妊娠期糖尿病 不同孕期 脂代谢 巨大儿 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]