空腹血糖变异性与妊娠期糖尿病风险的相关性分析  

Association between fasting blood glucose variability and the risk of developing gestational diabetes mellitus

作　　者：周佳伟 朱伟英[2,3] Zhou Jiawei;Zhu Weiying(Graduate School of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang Province,China;Department of Obstetrics,Jiaxing Maternity and Child Health Care Hospital,Jiaxing 314009,Zhejiang Province,China;Department of Obstetrics,Jiaxing Maternity and Child Health Care Hospital)

机构地区：[1]浙江中医药大学研究生院,杭州310053 [2]嘉兴市妇幼保健院产科,嘉兴314009 [3]嘉兴市妇幼保健院产科

出　　处：《中国基层医药》2024年第5期686-690,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省嘉兴市科技计划(2023AD31118)。

摘　　要：目的探讨空腹血糖变异性(GV)与妊娠期糖尿病(GDM)风险之间的相关性。方法选择嘉兴市妇幼保健院2022年1月至2023年4月收治的GDM患者90例为研究对象,根据75 g口服葡萄糖耐量试验(OGTT)结果中空腹血糖(FBG)水平将患者分为FBG正常组(A组,n=56)和FBG升高组(B组,n=34),采用多因素logistic二元回归分析确定GDM的独立危险因素,分析长期空腹血糖标准差(SDFBG)、空腹血糖变异系数(CVFBG)、空腹血糖平均连续变异性(ASVFBG)与GDM严重程度的关系。结果B组患者与A组患者的FBG[(6.83±1.03)mmol/L与(4.62±0.58)mmol/L]、1 h口服葡萄糖耐量试验(1hOGTT)[(13.03±1.39)mmol/L与(11.42±1.04)mmol/L]、2 h口服葡萄糖耐量试验(2hOGTT)[(10.23±1.51)mmol/L与(9.42±0.74)mmol/L]进行时间、组间、交互作用上比较,差异均有统计学意义(F=887.43、144.76、10.39,均P<0.05);B组糖化血红蛋白(HbA1c)水平均较A组明显偏高[(7.19±1.01)mmol/L与(5.03±0.42)mmol/L](t=14.15,P<0.05);与A组比较,B组患者的ASVFBG[(0.36±0.26)mmol/L与(0.58±0.23)mmol/L]、SDFBG[(0.41±0.21)mmol/L与(0.55±0.38)mmol/L]和CVFBG[(6.94±1.31)mmol/L与(9.43±2.45)mmol/L]值均明显偏高(t=4.06、2.25、6.28,均P<0.05)。B组患者的年龄和孕前身体质量指数(BMI)均较A组显著偏高(t=3.82、7.53,均P<0.05)。年龄、孕前BMI、FBG、1hFBG、2hFBG、HbA1c、ASVFBG、SDFBG和CVFBG是影响GDM重度病变的危险因素(OR=1.230、1.887、301.406、3.957、1.947、41.861、5.421、2.057,均P<0.05)。FBG的标准差(SDFBG)、平均连续变异性(ASVFBG)和变异系数(CVFBG)与GDM患者严重程度呈正相关(r=0.234、0.555、0.408,均P<0.05)。结论空腹血糖变异性与GDM风险呈正相关,年龄、孕前BMI、FBG、1hFBG、2hFBG、HbA1c、ASVFBG、SDFBG和CVFBG同时也是影响GDM重度病变的危险因素。Objective To investigate the association between fasting blood glucose(FBG)variability and the risk of developing gestational diabetes mellitus.Methods Ninety patients with gestational diabetes mellitus admitted to Jiaxing Maternity and Child Health Care Hospital between January 2022 and April 2023 were included in this study.Based on the blood glucose results obtained from the 75 g oral glucose tolerance test,these patients were divided into two groups:the normal blood glucose group(Group A,n=56)and the elevated blood glucose group(Group B,n=34).Multivariate logistic binary regression analysis was conducted to identify independent risk factors for gestational diabetes mellitus.Additionally,an analysis was conducted to investigate the association between long-term fasting blood glucose standard deviation(SDFBG),coefficient of variation(CVFBG),average successive variability of fasting blood glucose(ASVFBG),and the severity of gestational diabetes mellitus.Results The FBG levels[(6.83±1.03)mmol/L vs.(4.62±0.58)mmol/L],1-hour postprandial blood glucose[(13.03±1.39)mmol/L vs.(11.42±1.04)mmol/L],and 2-hour postprandial blood glucose[(10.23±1.51)mmol/L vs.(9.42±0.74)mmol/L]between the two groups(F=887.43,144.76,10.39,all P<0.05).Furthermore,the glycated hemoglobin levels were significantly elevated in Group B[(7.19±1.01)mmol/L]compared with Group A[(5.03±0.42)mmol/L,t=14.15,P<0.05).When compared with Group A,patients in Group B exhibited significantly higher values for ASVFBG[(0.58±0.23)mmol/L vs.(0.36±0.26)mmol/L],SDFBG[(0.55±0.38)mmol/L vs.(0.41±0.21)mmol/L],and CVFBG[(9.43±2.45)mmol/L vs.(6.94±1.31)mmol/L](t=4.06,2.25,6.28,all P<0.05).Additionally,the age and pre-pregnancy body mass index were significantly higher in Group B compared with Group A(t=3.82,7.53,both P<0.05).Age,pre-pregnancy body mass index,fasting blood glucose,1-hour postprandial blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,ASVFBG,SDFBG,and CVFBG were identified as risk factors for severe gestational diabetes mell

关 键 词：糖尿病 妊娠 血糖 危险因素 葡糖耐量试验 因素分析 统计学 

分 类 号：R714.256[医药卫生—妇产科学]