高龄孕妇孕中期OGTT结果与血清视黄醇结合蛋白4相关性分析  

Correlation Between Oral Glucose Tolerance Test and Retinol Binding Protein 4 During the Second Trimesters of Gestation in Advanced Pregnant Women

作　　者：石敏 倪爱华 李天爽 何珊 杨沐怿 王雅萍[1] 雷磊 Shi Min;Ni Aihua;Li Tianshuang(Department of Obstetrics and Gynecology,Nanjing First Hospital,Nanjing Medical University,Nanjing,Jiangsu 210006;Department of Maternity Health,Yuhuatai Maternity and Child Health Care Center,Nanjing,Jiangsu 210006,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院产科,江苏南京210006 [2]南京市雨花台区妇幼保健所孕产保健部,江苏南京210006

出　　处：《四川医学》2022年第10期1013-1017,共5页Sichuan Medical Journal

基　　金：南京医科大学科技发展基金资助项目(编号:NMUB2020211)。

摘　　要：目的探讨高龄孕妇孕中期口服葡萄糖耐量试验(OGTT)结果与血清视黄醇结合蛋白4(RBP4)水平相关性。方法选取2019年1月至2020年7月在我院建卡定期产检并分娩的孕妇245例,其中高龄组(≥35岁)98例、适龄组(<35岁)147例。比较两组孕妇孕中期OGTT结果、营养状况及血清RBP4水平,分析其相关性。结果两组孕妇BMI、分娩时体质量、孕期体质量增加,OGTT空腹血糖、2 h血糖及妊娠期糖尿病发病率比较,差异均无统计学意义(P>0.05);高龄组孕妇孕中期OGTT 1 h血糖升高明显(8.69±1.43 mmol/L vs.7.48±1.57 mmol/L),差异有统计学意义(P<0.05)。两组孕妇孕期营养摄入差异无统计学意义(P>0.05),高龄组基础代谢率下降(1372.22±116.47 kcal/d vs.1429.26±254.55 kcal/d)、体脂率显著升高[(32.57±5.46)%vs.(30.94±5.16)%],差异有统计学意义(P<0.05)。高龄组孕中期血清RBP4水平明显高于适龄组(38.95±12.34μg/ml vs.35.73±10.38μg/ml),差异有统计学意义(P<0.05);在调整年龄、体脂等血糖影响因素后,孕中期血清RBP4水平仍可作为OGTT 1 h血糖水平升高的危险因素(OR 1.15,95%CI 1.09~1.20,P<0.05)。结论高龄孕妇孕中期餐后血糖升高,升高的RBP4可能是其重要原因。Objective To investigate the correlation between oral glucose tolerance test(OGTT)results and serum levels of retinol binding protein 4(RBP4)during the 2nd trimesters of gestation in advanced maternal age(AMA).Methods 245 pregnant women were selected from patients who received routine prenatal care and delivered in our hospital between January 2019 and July 2020.These patients were divided into AMA group(≥35yrs old,n=98)and control group(<35yrs old,n=147).OGTT,dietary survey and serum RBP4 measurements were taken during the 2nd trimesters of gestation.Results There was no significant difference in BMI,pre-delivery weight,gestational weight gain,OGTT fasting blood glucose,two-hour blood glucose and incidence of gestational diabetes between the two groups(P>0.05).Glucose levels measured at 1 hour increased significantly from baseline in AMA group(8.69±1.43 mmol/L vs.7.48±1.57 mmol/L)(P<0.05).Despite lack of significant difference in nutritional intake between the two groups,AMA patients exhibited lower basal metabolic rates(1372.22±116.47 kcal/d vs.1429.26±254.55 kcal/d)and higher percentage of body fat[(32.57±5.46)%vs.(30.94±5.16)%]than those of the control group.Moreover,mid-gestational serum RBP4 level was significantly higher in AMA group compared to that in the control group(38.95±12.34μg/ml vs.35.73±10.38μg/ml)(P<0.05)and correlated with 1 hour glucose level from OGTT(OR 1.15,95%CI 1.09~1.20,P<0.05).Conclusion AMA pregnancy is associated with elevated postprandial blood glucose,with increased RBP4 being a potential contributing factor for that.

关 键 词：高龄孕妇 口服葡萄糖耐量试验 视黄醇结合蛋白4 

分 类 号：R714.256[医药卫生—妇产科学]