妊娠期糖尿病患者妊娠早期TyG指数与分娩小于胎龄儿的相关性  

The relationship between TyG index in early pregnancy and the delivery of small for gestational age infant in patients with gestational diabetes mellitus

作　　者：努尔比亚·西里甫 李章燕 臧淑妃 古力斯坦·艾斯卡尔 张瑞 李悦 徐鑫铭 刘军 Nuerbiya Xilifu;LI Zhang-yan;ZANG Shu-fei;Gulisitan Aisikaer;ZHANG Rui;LI Yue;XU Xin-ming;LIU Jun(Department of Endocrinology,Shanghai Fifth People’s Hospital,Fudan University,Shanghai 200240,China;Department of Endocrine Metabolism,the Second People’s Hospital of Kashgar Prefecture,Kashgar 844000,Xinjiang Uygur Autonomous Region,China;Graduate School of Xinjiang Medical University,Urumqi 830017,Xinjiang Uygur Autonomous Region,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 [2]喀什地区第二人民医院内分泌代谢科,喀什844000 [3]新疆医科大学研究生院,乌鲁木齐830017

出　　处：《复旦学报（医学版）》2024年第3期352-358,377,共8页Fudan University Journal of Medical Sciences

基　　金：上海市“科技创新行动计划”生物医药科技支撑专项基金(21S31901800)。

摘　　要：目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者妊娠早期甘油三酯葡萄糖指数(the triglyceride-gluscose index,TyG指数)与分娩小于胎龄儿(small for gestational age infant,SGA)之间的关系。方法选取2018年1月至2023年6月复旦大学附属上海市第五人民医院和新疆喀什地区第二人民医院产科孕早期建档并符合纳入标准的孕妇1532例为研究对象,根据孕妇24~28周行口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)结果,将其分为GDM组(754例)及非GDM组(778例)。GDM组患者根据新生儿体重,将其分为SGA组、大于胎龄儿(large for gestational age infant,LGA)组和适于胎龄儿(appropriate for gestational age infant,AGA)组。分析GDM患者分娩SGA的独立影响因素,采用Logistic回归模型分析TyG指数与发生SGA的相关性。绘制ROC曲线以分析妊娠早期TyG指数对GDM患者分娩SGA的预测价值。结果GDM患者SGA组TyG指数显著低于LGA组、AGA组及非GDM组(P<0.05);多因素Logistic回归分析结果显示,TyG指数与GDM患者分娩SGA的发生独立相关(P<0.05);ROC曲线结果显示,妊娠早期TyG指数对GDM患者分娩SGA具有较好的预测价值(AUC=0.821,95%CI:0.763~0.879,P<0.001)。结论GDM患者妊娠早期TyG指数与分娩SGA之间存在独立相关,对于GDM患者分娩SGA具有较好的预测价值。Objective To investigate the relationship between triglyceride-gluscose(TyG)index in early pregnancy and the delivery of small for gestational age infant(SGA)in patients with gestational diabetes mellitus(GDM).Methods A total of 1532 pregnant women from Shanghai Fifth People’s Hospital and the Second People’s Hospital of Kashgar Region,who were enrolled in the study between Jan 2018 and Jun 2023 and met the inclusion criteria,were categorized into the group with GDM(754 cases)and the group without GDM(778 cases)based on the results of the oral glucose tolerance test(OGTT)conducted at 24-28 weeks of pregnancy.Within the GDM group,patients were further categorized into 3 groups based on neonatal weight:SGA group,large for gestational age infant(LGA)group,and appropriate for gestational age infant(AGA)group.A Logistic regression model was used to analyze the independent influences on SGA delivery in patients with GDM to analyze the correlation between the TyG index and the occurrence of SGA.The predictive value of the TyG index in early pregnancy for SGA delivery in GDM patients was analyzed using ROC curves.Results The TyG index in the SGA group of GDM patients was significantly lower than that in the LGA,AGA and control without GDM group(P<0.05).Multifactorial logistic regression analysis revealed that the TyG index was independently correlated with the SGA in GDM patients(P<0.05).The ROC curve analysis demonstrated a good predictive value of the TyG index in early gestation for SGA delivery in GDM patients(AUC=0.821,95%CI:0.763-0.879,P<0.001).Conclusion The TyG index in early pregnancy among GDM patients is independently correlated with the occurrence of SGA infants and has a good predictive value for SGA delivery in GDM patients.

关 键 词：妊娠期糖尿病(GDM) 妊娠早期 甘油三酯葡萄糖(TyG指数) 小于胎龄儿(SGA) 

分 类 号：R714.256[医药卫生—妇产科学]