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预防医学  2018, Vol. 30 Issue (8): 762-765,770    DOI: 10.19485/j.cnki.issn2096-5087.2018.08.002
  论著 本期目录 | 过刊浏览 | 高级检索 |
妊娠中期糖脂代谢水平与妊娠结局的相关性分析
王丽君1,甘培元2,何丽雅2,陆怡2,何文芳2,徐泽汝2,郭君平2,华燕吟1
1.浙江省人民医院(杭州医学院附属人民医院),浙江 杭州 310014
2.浙江大学城市学院
Association between glucose and lipid metabolism during the second trimester and pregnancy outcomes
WANG Li-jun*,GAN Pei-yuan,HE Li-ya,LU Yi,HE Wen-fang,XU Ze-ru,GUO Jun-ping ,HUA Yan-yin
*Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou,Zhejiang 310014,China
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摘要 目的 探讨妊娠中期糖脂代谢特点以及与不良妊娠结局的相关性。方法 纳入2014年6月—2017年5月在浙江省人民医院行产前检查并分娩的268名孕妇为研究对象,其中妊娠糖尿病(GDM)组110例,糖耐量正常(NGT)组158人,收集两组研究对象一般资料、妊娠并发症和妊娠结局等临床资料,采集妊娠中期外周血检测空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和血尿酸(UA)等生化指标,比较两组间各指标差异,并采用Logistic回归模型分析妊娠中期血糖、血脂和尿酸等指标对妊娠结局的影响。结果 GDM组的年龄、FBG、TC、TG、LDL-C和UA水平均高于NGT组,而HDL-C低于NGT组(P<0.05)。GDM组剖腹产、巨大儿和早产儿的发生率均高于NGT组(P<0.05)。多因素Logistic回归分析结果显示,年龄增加(OR=1.068,95%CI:1.006~1.133)、高TG(OR=2.078,95%CI:1.157~3.731)、高LDL-C(OR=2.047,95%CI:1.179~3.552)、高UA(OR=9.165,95%CI:1.964~45.056)、高FBG(OR=17.384,95%CI:2.098~144.026)是GDM的独立危险因素,高HDL-C(OR=0.370,95%CI:0.015~0.944)是GDM的保护因素;年龄大(OR=1.073,95%CI:1.015~1.134)是剖腹产的独立危险因素;高TG(OR=2.939,95%CI:1.128~7.659)是娩出巨大儿的独立危险因素;年龄大(OR=1.132,95%CI:1.005~1.274)和高LDL-C(OR=3.512,95%CI:1.033~11.937)是娩出早产儿的独立危险因素。结论 妊娠中期糖脂代谢异常与不良妊娠结局相关。
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王丽君
甘培元
何丽雅
陆怡
何文芳
徐泽汝
郭君平
华燕吟
关键词 妊娠糖尿病血糖血脂血尿酸妊娠结局    
AbstractObjective To analyze the association between glucose and lipid metabolism during the second trimester and pregnancy outcomes.Methods A total of 268 pregnant women who underwent prenatal examination and baby delivering at Zhejiang Provincial People's Hospital during June 2014 to may 2017 were recuited. 110 of those subjects were diagnosed with gestational diabetes mellitus(GMD). The level of fasting blood glucose(FBG),total cholesterol (TC),triglyceride (TG),high-density lipoprotein (HDL-C),low-density lipoprotein cholesterol (LDL-C),uric acid (UA) and other metabolism indexes were measured during the second trimester. Data including demographic features,pregnancy complications and pregnancy outcomes were also collected. Logistic regression model was applied to analyze the association between glucose and lipid metabolism during the second trimester and pregnancy outcomes.Results Age and the levels of FBG,TC,TG,LDL-C and UA in GDM group were significantly higher than the normal glucose tolerance(NGT) group,while the level of HDL-C were significantly lower(P<0.05). The incidence of cesarean section,macrosomia and premature were higher in GDM group than that in NGT group(P<0.05). The rise of age(OR=1.068,95%CI:1.006-1.133) and the levels of TG(OR=2.078,95%CI:1.157-3.731),LDL-C(OR=2.047,95%CI:1.179-3.552),UA(OR=9.165,95%CI:1.964-45.056)and FBG(OR=17.384, 95%CI:2.098-144.026) would increase the risk of GMD,while the increase of HDL-C(OR=0.370,95%CI:0.015-0.944) had opposite effect. Pregnant women with advanced age were more likely to go through cesarean section(OR=1.073,95%CI:1.015-1.134). TC level (OR=2.939,95%CI:1.128-7.659)and macrosomia had a positive correlation. Age(OR=1.132, 95%CI:1.005-1.274)and LDL-C level(OR=3.512,95%CI:1.033-11.937)were positively related with premature.Conclusion The disorder of glucose and lipid metabolism during the second trimester may affect the pregnancy outcomes.
Key wordsGestational diabetes mellitus    Blood glucose    Blood lipids    Uric acid    Pregnancy outcomes
          出版日期: 2018-07-25
中图分类号:  R715.3  
基金资助:浙江省医药卫生科技项目(2014KYB027);浙江大学城市学院2018年度大学生科研项目(X2018556141)
通信作者: 华燕吟,E-mail:yanyinhua@gmail.com   
作者简介: 王丽君,硕士,主治医师,主要从事内分泌临床工作和妊娠糖尿病的研究工作
引用本文:   
王丽君, 甘培元, 何丽雅, 陆怡, 何文芳, 徐泽汝, 郭君平, 华燕吟. 妊娠中期糖脂代谢水平与妊娠结局的相关性分析[J]. 预防医学, 2018, 30(8): 762-765,770.
WANG Li-ju, GAN Pei-yuan, HE Li-ya, LU Yi, HE Wen-fang, XU Ze-ru, GUO Jun-ping , HUA Yan-yin. Association between glucose and lipid metabolism during the second trimester and pregnancy outcomes. Preventive Medicine, 2018, 30(8): 762-765,770.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2018.08.002      或      http://www.zjyfyxzz.com/CN/Y2018/V30/I8/762
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