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| 孕早期空腹血糖、年龄、孕前BMI等因素 对妊娠期糖尿病发生的影响分析 |
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| 投稿时间：2024-06-26 修订日期：2025-05-03 |
| 中文关键词: 妊娠期糖尿病 空腹血糖 年龄 体质指数 |
| 英文关键词: gestational diabetes mellitus (GDM) fasting blood glucose (FBG) age body mass index (BMI) |
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| 中文摘要: |
| 【】目的:探讨孕早期空腹血糖(fasting blood glucose, FBG)、年龄、孕早期体重增长及孕前体质指数(BMI)与妊娠期糖尿病(gestational diabetes mellitus, GDM)发生的关系。方法:选取2021年1月-2022年12月就诊银川市妇幼保健院产科门诊,在24-28周进行75g葡萄糖耐量试验(oral glucose tolerance test, OGTT)的孕妇4432例,进行回顾性调查,根据筛查结果分为GDM组(596例)、非GDM组(3836例),了解人群GDM 发病情况,分析孕早期体重增长、孕前BMI、年龄及孕早期FBG在 GDM 预测中的意义。结果:孕早期FBG平均值为4.52±0.359mmol/L。不同孕前BMI、年龄孕妇测得孕早期FBG值差异均有统计学意义(P<0.05),高龄组高于正常年龄组,孕前BMI≥24kg/m2组高于<24 kg/m2组。不同孕前BMI孕妇,其孕早期FBG区间差异有统计学意义(P<0.05)；4432例孕妇共诊断GDM 596例,发病率13.38%,年龄≥ 35岁组高于<35岁组(18.91% vs 12.76%),≥ 24 kg/m2组高于18.5~23.9 kg/m2和<18.5 kg/m2组(24.6% vs11.6% vs 5.6%), 孕早期体重增长过多组高于体重增长正常组(15.9% vs 12.2%),孕早期空腹血糖越高、GDM发生率越高,差异均有统计学意义(P<0.05)；将孕早期FBG水平分为<4.40mmol/L组、4.40~4.99mmol/L组,5.00~5.39mmol/L组和≥5.40mmol/L组,其不同组孕妇GDM发病率分别为6.7%、13.5%、37.4%和63.6%,将孕前BMI、孕早期体重增长和年龄进行分层,除BMI<18.5kg/m2 组未发现统计学差异外,其余组孕妇在不同孕早期FBG 区段GDM 发生率差异,均有统计学意义(P<0.05)。结论:孕早期FBG、年龄、孕前BMI及孕早期体重增长情况与 GDM 发病有关,孕前高 BMI、孕早期过高的FBG及过多的体重增长均会增加 GDM 风险,如同时伴高龄会大大增加GDM的发生,这类人群应尽早监测、干预,做好孕期保健管理。 |
| 英文摘要: |
| Objective: To explore the relationship between fasting blood glucose (fasting blood glucose, FBG), age, weight gain and early pregnancy and the occurrence of gestational diabetes mellitus (gestational diabetes mellitus, GDM). Methods: 4432 pregnant women were selected to the obstetrics clinic of Yinchuan Maternal and Child Health Hospital for 75g glucose tolerance test (oral glucose tolerance test, OGTT) from January 2021 to December 2,2022, and were divided into GDM group (596 cases) and non-GDM group (3836 cases) at 24-28 weeks, to understand the incidence of GDM, pre-pregnancy BMI, age and the significance of FBG in GDM prediction. Results: The mean value of FBG in the first trimester was 4.52±0.359mmol/L. The difference in FBG values of different pregnant women were statistically significant (P <0.05), and the advanced age group was higher than the normal age group, and the pre-pregnancy BMI 24 kg/m2 group was higher than the <24 kg/m2 group. Pregnant women with different prepregnancy BMI,The difference of FBG interval in early pregnancy was significant (P <0.05); 4432 pregnant women codiagnosed GDM 596, The incidence rate was 13.38%, Age at the 35 years group was higher than that in the <35 years group (18.91% vs 12.76%), 24 kg/m2 was higher than 18.5 to 23.9 kg/m2 and <18.5 kg/m2 (24.6% vs11.6% vs 5.6%), Excessive weight gain in early pregnancy was higher than that in the normal weight gain group (15.9% vs 12.2%), Higher fasting blood glucose and a higher incidence of GDM in early pregnancy, The differences were all statistically significant (P <0.05); FBG levels into <4.40 mmol/L and 4.40~4.99mmol/L groups, The 5.00~5.39mmol/L group and the 5.40 mmol/L group, Its incidence of maternal GDM in different groups was 6.7%, 13.5%, 37.4% and 63.6%, respectively, Stratifying measures for prepregnancy BMI, early pregnancy weight gain, and age, Except that no statistical differences were found in the BMI<18.5kg/m2 group, The ences of GDM in different FBG sections in the remaining groups, All were statistically significant (P <0.05). Conclusion: FBG, age, pre-pregnancy BMI, and weight gain in early pregnancy are related to the incidence of GDM. High BMI, pre-pregnancy FBG in early pregnancy and excessive weight gain will increase the risk of GDM, especially in elderly pregnant women, which greatly increases the occurrence of GDM, and should be monitored and intervened as early as possible to reduce the occurrence of GDM. |
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