妊娠糖尿病患者血糖控制不佳的危险因素  

Risk Factors for Poor Blood Sugar Control in Patients with Gestational Diabetes Mellitus

作　　者：马会峰[1] 靳闪闪 薛玲玲[1] MA Huifeng;JIN Shanshan;XUE Lingling(Department of Obstetrics and Gynecology,Henan University of Science and Technology First Affiliated Hospital New Area Hospital,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院新区医院妇产科,河南洛阳471000

出　　处：《河南医学研究》2025年第2期272-276,共5页Henan Medical Research

摘　　要：目的探讨妊娠糖尿病(GDM)患者血糖控制不佳的危险因素及血清肥胖抑制素、果糖胺(FRU)、神经调节蛋白4(NRG4)的预测价值。方法回顾性分析2021年1月至2022年6月河南科技大学第一附属医院新区医院收治的90例GDM患者的临床资料,根据患者产前空腹血糖(FBG)是否达到3.3~5.3 mmol·L^(-1)分为血糖控制良好组(47例)及血糖控制不佳组(43例)。比较两组临床资料,并采用多因素logistic回归分析法分析影响GDM患者血糖控制不佳的危险因素,采用受试者工作特征(ROC)曲线分析血清肥胖抑制素、FRU、NRG4对GDM患者血糖控制不佳的预测价值。结果多因素logistic回归分析结果显示,孕前体重指数(BMI)高、遵医嘱用药评分低、饮食控制评分低、血清肥胖抑制素水平低、有其他妊娠合并症、血清FRU水平高、血清NRG4水平高是影响GDM患者血糖控制不佳的独立危险因素(P<0.05)。血清肥胖抑制素、FRU、NRG4及联合检查诊断GDM患者血糖控制不佳的曲线下面积(AUC)分别为0.656、0.630、0.706及0.848,敏感度分别为67.44%、69.77%、65.12%及79.07%,特异度分别为68.09%、65.96%、68.09%及78.72%,其中联合检查的AUC、敏感度及特异度最高(P<0.05)。结论年龄大、孕前BMI高、遵医嘱用药评分低、饮食控制评分低、血清肥胖抑制素水平低、初中及以下、有其他妊娠合并症、血清FRU水平高、血清NRG4水平高是影响GDM患者血糖控制不佳的危险因素,且可根据患者血清肥胖抑制素、FRU、NRG4变化情况评估血糖控制效果,而三者联合检查的预测价值最高,临床可制定针对性的治疗及干预措施,以改善血糖控制效果。Objective To explore the risk factors of poor blood glucose control in patients with gestational diabetes mellitus(GDM)and the predictive value of serum obestatin,fructosamine(FRU)and neuregulin 4(NRG4).Methods The clinical data of 90 patients with GDM admitted to Henan University of Science and Technology First Affiliated Hospital New Area Hospital from January 2021 to June 2022 were retrospectively analyzed.According to whether the selected patients'prenatal fasting blood glucose(FBG)reached 3.3-5.3 mmol·L^(-1),they were divided into the good blood sugar control group(47 cases)and the poor blood sugar control group(43 cases).The clinical data of the two groups were compared,and the multivariate logistic regression analysis was used to analyze the risk factors for poor blood sugar control in GDM patients.The predictive value of serum obestatin,FRU,and NRG4 for poor blood glucose control in patients with GDM was analyzed by the receiver operating characteristic(ROC)curve.Results The results of multivariate logistic regression analysis showed that high pre-pregnancy BMI,low score of medication compliance,low score of dietary control,low level of serum obestatin,other pregnancy complications,high levels of serum FRU and high levels of serum NRG4 were independent risk factors for poor blood sugar control in patients with GDM(P<0.05).The area under curve(AUC)for diagnosing poor blood glucose control in GDM patients with serum obestatin,FRU,NRG4,and combined examination were 0.656,0.630,0.706,and 0.848,respectively,with sensitivity of 67.44%,69.77%,65.12%,and 79.07%,and specificity of 68.09%,65.96%,68.09%,and 78.72%,respectively.The AUC,sensitivity,and specificity of combined examination were the highest(P<0.05).Conclusion Older age,high pre-pregnancy BMI,low medication compliance scores,low dietary control scores,low level of serum obestatin,junior high school and below,other pregnancy complications high levels of serum FRU,and high levels serum NRG4 were risk factors for poor glycemic control in patients with GDM.T

关 键 词：妊娠糖尿病 血糖 危险因素 

分 类 号：R714.256[医药卫生—妇产科学]