妊娠早期甘油三酯葡萄糖指数对妊娠期糖尿病孕妇糖脂代谢的影响  

Impact of Triglyceride Glucose Index during Early Pregnancy on Glucose and Lipid Metabolism in Gestational Diabetes Mellitus

作　　者：江志发 叶湘云 曹丹丹 陈平 李仲均[2] JIANG Zhifa;YE Xiangyun;CAO Dandan(Department of Obstetrics,Huizhou First Maternal and Child Health Care Hospital,Guangdong 516007,China)

机构地区：[1]惠州市第一妇幼保健院产科,516007 [2]南方医科大学附属东莞人民医院妇产科、东莞市妇产科重大疾病重点实验室,523017

出　　处：《医学研究杂志》2024年第11期127-132,共6页Journal of Medical Research

基　　金：广东省惠州市科技研发项目(2021WC0106200)。

摘　　要：目的 探究妊娠早期甘油三酯葡萄糖指数(triglyceride glucose index, TyG指数)对妊娠期糖尿病糖脂代谢的影响。方法 选取2021年5月~2022年8月在惠州市第一妇幼保健院建档并分娩的妊娠期糖尿病产妇527例,依据妊娠早期TyG指数分为T1组(<8.273,n=176)、T2组(8.273~8.590,n=175)、T3组(≥8.590,n=176)。比较3组妊娠各期的糖脂代谢和母胎妊娠结局指标,探讨TyG指数对糖脂代谢的影响。结果 3组中随着TyG指数升高,孕次、产次、新生儿体重升高,巨大儿、剖宫产发生率均上升,差异均有统计学意义(P<0.05);妊娠晚期和产褥期总胆固醇、高密度脂蛋白胆固醇、甘油三酯均升高,而低密度脂蛋白胆固醇下降,差异均有统计学意义(P<0.05)。进一步分析产褥期代谢指标显示,3组间的空腹血糖受损、葡萄糖耐量受损等糖代谢指标差异无统计学意义(P>0.05);而高胆固醇血症、高甘油三酯血症、高密度脂蛋白胆固醇下降等脂代谢异常发生率明显升高,差异有统计学意义(P<0.05)。结论 妊娠早期高TyG指数可影响妊娠期糖尿病妊娠晚期和产褥期的糖脂代谢,增加产褥期脂代谢异常的发生。Objective To investigate the impact of triglyceride glucose index(TyG index)during early pregnancy on glucose and lipid metabolism in gestational diabetes mellitus.Methods A total of 527 pregnant women with gestational diabetes mellitus who delivered at the Huizhou First Maternal and Child Health Care Hospital from May 2021 to August 2022 were selected.Based on the early pregnancy TyG index,they were categorized into T1group(<8.273,n=176),T2group(8.273-8.590,n=175),T3group(≥8.590,n=176).The glucose and lipid metabolism at different stages of pregnancy and maternal-fetal outcomes among the three groups were compared,and to explore the influence of the TyG index on on glucose and lipid metabolism.Results As the TyG index increased in the three groups,gestational times,delivery times,newborn weight,rates of macrosomia,and cesarean section all increased significantly(P<0.05).In the third pregnancy and postpartum,total cholesterol,high-density lipoprotein cholesterol and triglycerides increased,while low-density lipoprotein cholesterol decreased,showing statistical significance(P<0.05).Further analysis during the postpartum period revealed no statistical differences in impaired fasting glucose and impaired glucose tolerance among the groups(P>0.05).However,the incidence of abnormal lipid metabolism such as hypercholesterolemia,hypertriglyceridemia,and decreased high-density lipoprotein cholesterol significantly increased,and the difference was statistically significant(P<0.05).Conclusion A high TyG index in early pregnancy can impact lipid metabolism in the third pregnancy and the postpartum period for women with gestational diabetes mellitus,increasing the occurrence of lipid metabolism abnormalities.

关 键 词：糖尿病 妊娠 甘油三酯葡萄糖指数 糖代谢紊乱 脂代谢异常 

分 类 号：R714[医药卫生—妇产科学] R715[医药卫生—临床医学]