妊娠前体重指数、妊娠年龄及妊娠早期甘油三酯水平对妊娠期糖尿病的预测价值  

Predictive value of pre-pregnancy BMI,gestational age and triglyceride in early gestation for gestational diabetes mellitus

作　　者：赵红梅 孙田歌 黄新梅 于志艳 杨敏 王芳 刘梦 刘军 Zhao Hongmei;Sun Tiange;Huang Xinmei;Yu Zhiyan;Yang Min;Wang Fang;Liu Meng;Liu Jun(Department of Endocrinology,Shanghai Fifth People’s Hospital,Fudan University,Shanghai 200240,China)

机构地区：[1]复旦大学附属上海市第五人民医院内分泌科,上海200240

出　　处：《临床内科杂志》2021年第3期166-168,共3页Journal of Clinical Internal Medicine

基　　金：上海市内分泌重点专科项目(ZK2019B15);上海市第五人民医院重点项目(2018WYZD04)。

摘　　要：目的探讨妊娠前体重指数(BMI)、妊娠年龄及妊娠早期甘油三酯(TG)水平对妊娠期糖尿病(GDM)的预测价值。方法收集于我院常规产检和住院分娩的孕妇162例,按照妊娠24~28周口服葡萄糖耐量试验(OGTT)结果将其分为对照组(89例)与GDM组(73例)。比较两组孕妇的临床资料及妊娠早期生化指标,采用logistic多因素回归分析筛选GDM发生的独立危险因素,采用受试者工作特征(ROC)曲线评估相关指标对GDM的预测价值。结果GDM组孕妇的年龄、BMI及妊娠早期空腹血糖、TG、载脂蛋白、白细胞计数、中性粒细胞计数、淋巴细胞计数、血小板计数、ALT、血尿酸均明显高于对照组,而妊娠早期总胆红素、直接胆红素水平均明显低于对照组(P<0.05)。妊娠前BMI、妊娠年龄、妊娠早期TG较高均为GDM的独立危险因素(P<0.05)。预测GDM发生的妊娠前BMI、妊娠年龄、妊娠早期TG的最佳界值分别为22.53 kg/m2、32.5岁和1.72 mmol/L。结论妊娠前BMI、妊娠年龄、妊娠早期TG水平较高是GDM发生的独立危险因素,提示妊娠前减重、适龄生育有助于减少GDM的发生。Objective To study the predictive value of pre-pregnancy BMI,gestational age and triglyceride in early gestation for gestational diabetes mellitus(GDM).Methods A total of 162 pregnant women who had a routine prenatal examination and delivery in our hospital were collected.According to the results of OGTT at 24-28 weeks,they were divided into control group(89 cases)and GDM group(73 cases).Compare the clinical data and early-pregnancy biochemical indicators of the two groups.Logistic multivariate analysis was conducted to screen independent risk factors of GDM and receiver operating characteristic(ROC)curve was conducted to evaluate the predictive value of related indicators for GDM.Results Pregnant women in the GDM group had higher age,BMI,fasting plasma glucose,TG,apolipoprotein,leukocyte count,neutrophil count,lymphocyte count,platelet count,ALT,blood uric acid in early pregnancy than those of control group,while had lower total bilirubin,direct bilirubin level in early pregnancy than those of control group(P<0.05).Pre-pregnancy BMI,gestational age and TG increased in early pregnancy were independent risk factors for GDM(P<0.05).The best cut-off point of pre-pregnancy BMI,gestational age and TG in early pregnancy for the predicting GDM were 22.53 kg/m2,32.5 years old and 1.72 mmol/L.Conclusion Higher pre-pregnancy BMI,gestational age and TG in early pregnancy are independent risk factors for GDM,which indicate weight loss before pregnancy and appropriate fertility age help to reduce the incidence of GDM.

关 键 词：妊娠期糖尿病 妊娠前BMI 妊娠年龄 妊娠早期 甘油三酯 预测价值 

分 类 号：R714.25[医药卫生—妇产科学]