妊娠期糖尿病并发脂代谢紊乱的危险因素  

Risk factors of gestational diabetes mellitus complicated with lipid metabolism disorder

作　　者：金鑫[1] 吴艳[1] Jin Xin;Wu Yan(Department of Obstetrics and Gynecology,Hefei Third People's Hospital,Hefei 230000)

机构地区：[1]合肥市第三人民医院妇产科,合肥230000

出　　处：《现代妇产科进展》2021年第6期426-429,共4页Progress in Obstetrics and Gynecology

摘　　要：目的分析妊娠期糖尿病(GDM)并发脂代谢紊乱的危险因素。方法回顾分析合肥市第三人民医院妇产科2016年2月~2018年5月收治的300例GDM患者的资料,统计脂代谢紊乱发生率和妊娠结局,分析发生脂代谢紊乱的危险因素。结果脂代谢紊乱发生率为25.33%(76/300)。GDM并发脂代谢紊乱组的母体、围产儿不良妊娠结局发生率均高于未并发组(P<0.05);并发组高龄产妇、孕前肥胖、高脂血症家族史、合并妊娠期高血压疾病、高脂饮食、合并多囊卵巢综合征、血糖控制依从性差、胰岛素抵抗者构成比均明显高于未并发组(P<0.05);两组的孕期体质量增幅、载脂蛋白B、脂蛋白a、脂蛋白脂酶、血清瘦素水平分布差异显著(P<0.05),其中并发组孕期体质量增幅偏大、载脂蛋白B>1.12g/L、脂蛋白a>140mmol/L、脂蛋白脂酶>2.25mmol/L、血清瘦素>22.1g/L者构成比均明显高于未并发组(P<0.05)。高龄产妇、孕前肥胖、高脂血症家族史、合并妊娠期高血压疾病、孕期体质量增幅偏大、高脂饮食、合并多囊卵巢综合征、载脂蛋白B>1.12g/L、脂蛋白a>140mmol/L、脂蛋白脂酶>2.25mmol/L、血糖控制依从性差、胰岛素抵抗、血清瘦素水平>22.1g/L均是影响GDM并发脂代谢紊乱的独立危险因素(OR=19.144、7.286、6.521、6.315、4.315、7.142、6.521、6.740、5.501、6.633、5.507、6.117、6.794,P<0.05)。结论GDM并发脂代谢紊乱的风险高,且不良妊娠结局发生率较高,高龄产妇、孕前肥胖、高脂血症家族史、合并妊娠期高血压疾病等均是其危险因素。Objective:To analyze the risk factors of gestational diabetes mellitus complicated with lipid metabolism disorder.Methods:The data of 300 patients with gestational diabetes mellitus admitted to Hefei Third People's Hospital from February 2016 to May 2018 were retrospectively analyzed.The incidence of lipid metabolism disorder and pregnancy outcomes were counted.The risk factors of gestational diabetes mellitus complicated with lipid metabolism disorder were analyzed.Results:The incidence of dyslipidemia was 25.33%(76/300).The incidences of maternal and perinatal adverse pregnancy outcomes in the complicated group were higher than those in the non complicated group(P<0.05).The constituent ratios of elderly puerpera,pre pregnancy obesity,family history of hyperlipidemia,pregnancy induced hypertension,high-fat diet,polycystic ovary syndrome,poor compliance of blood glucose control and insulin resistance in the complicated group were significantly higher than those in the non complicated group(P<0.05).There were significant differences between the two groups in gestational weight gain,apolipoprotein B,lipoprotein a,lipoprotein lipase and serum leptin levels(P<0.05),and the constituent ratios of the complicated group with larger gestational weight gain,apolipoprotein B>1.12g/L,lipoprotein a>140mmol/L,lipoprotein lipase>2.25mmol/L and serum leptin>22.1g/L were significantly higher than those of the non complicated group(P<0.05).Elderly women,pre pregnancy obesity,family history of hyperlipidemia,hypertensive disorder complicating pregnancy,high-fat diet,polycystic ovary syndrome,apolipoprotein B>1.12g/L,lipoprotein a>140mmol/L,lipoprotein lipase>2.25mmol/L,poor compliance of blood glucose control,insulin resistance,serum leptin level>22.1g/L were the risk factors for GDM complicated with lipid metabolism Independent risk factors of the disorder(OR=19.144,7.286,6.521,6.315,4.315,7.142,6.521,6.740,5.501,6.633,5.507,6.117,6.794,P<0.05).Conclusion:The risk of gestational diabetes mellitus complicated with lipid metabolism

关 键 词：妊娠期糖尿病 脂代谢紊乱 危险因素 

分 类 号：R714.2[医药卫生—妇产科学]