妊娠期糖尿病孕妇产后1年糖代谢转归及影响因素分析  

Analysis of the conversion and the influence factors of glucose metabolism of women with gestational diabetes mellitus 1 years after delivery

作　　者：朱瑞丹[1] 贺惠琼 程丽丽[1] ZHU Ruidan;HE Huiqiong;CHENG Lili(The Second Maternal and Child Health Care Hospital of Huizhou, Guangdong Province, 516001;The Third People's Hospital of Huizhou)

机构地区：[1]广东省惠州市第二妇幼保健院,516001 [2]广东省惠州市第三人民医院

出　　处：《中国计划生育学杂志》2021年第11期2336-2340,共5页Chinese Journal of Family Planning

摘　　要：目的:跟踪评估妊娠期糖尿病产妇产后6~8周、1年糖代谢转归情况并分析转归失败影响因素。方法:选取2019年1月-2020年1月在本院分娩且孕期确诊为妊娠期糖尿病的患者100例,分别在产后6~8周和1年时复查行75g口服葡萄糖耐量试验,跟据糖代谢指标将100例患者分为正常组和异常组,分析糖代谢异常影响因素。结果:产后6~8周时糖代谢异常45例(45.0%),糖尿病14例(14.0%)、葡萄糖耐量受损(IGT)21例(21.0%),空腹血糖受损(IFG)10例(10.0%);1年时糖代谢异常42例(42.0%),其中15例为糖尿病(15.0%),18例为IGT(18.0%),9例为IFG(9.0%);产后1年时糖尿病累积发病率为15.0%(15/100)。logistic多因素逐步回归分析显示,孕期体质指数≥28kg/m^(2)、诊断孕周越早、1h PG水平越高、胰岛素抵抗指数(HOMA-IR)越大则妊娠期糖尿病孕妇产后1年糖代谢转归失败的风险越大(P<0.05)。结论:妊娠期糖尿病孕妇产后1年内糖代谢异常率较高,临床对产后短期糖代谢转归失败的风险因素需引起足够重视。Objective:To evaluate the conversion situation of glucose metabolism of women with gestational diabetes mellitus(GDM)within 6-8 weeks and 1 year after delivery,and to study the influencing factors of the conversion failure of abnormal glucose metabolism of the women after delivery.Methods:100 women who had been diagnosed as GDM during pregnancy from January 2019 to January 2020 were selected as study objects.75g oral glucose tolerance test of these women was performed in 6-8 weeks and 1 year after delivery.Based on the postpartum glucose metabolism indexes,these 100 women were divided in normal glycometabolism group and abnormal glycometabolism group.The influence factors of abnormal glucose metabolism were analyzed.Results:When 6-8 weeks after delivery,there were 45(45.0%)women with abnormal glucose metabolism,which included 14(14.0%)women with diabetes,21(21.0%)women with impaired glucose tolerance(IGT),and 10(10.0%)women with impaired fasting glucose(IFG).1 year after delivery,there were 42(42.0%)women with abnormal glucose metabolism,which included 15(15.0%)women with diabetes,18(18.0%)women with IGT,and 9(9.0%)women with IFG.The cumulative incidence of diabetes of the women within 1 year after delivery was 15.0%(15/100).Logistic multivariate stepwise regression analysis showed that the risk of conversion failure of abnormal glucose metabolism of the women with body mass index≥28kg/m^(2) during pregnancy,with early gestational weeks when GDM diagnosis,with higher 1h PG level,or with higher insulin resistance index(HOMA-IR)in 1 year after delivery was higher(P<0.05).Conclusion:The rate of abnormal glucose metabolism of the women with GDM in 1 year after delivery is high,so it should be paid more attention to the risk factors of postpartum short-term glucose metabolism conversion failure in clinic.

关 键 词：妊娠期糖尿病 产后糖代谢转归 葡萄糖耐量试验 影响因素 

分 类 号：R58[医药卫生—内分泌]