摘要
目的探讨不同孕前身体质量指数(BMI)水平孕妇葡萄糖耐量试验(OGTT)血糖值的特点,并分析不同孕前BMI与妊娠期糖尿病(GDM)检出率的相关性。方法回顾性收集2015年1月至2017年12月在海南省海口市妇幼保健院住院分娩并接受75g OGTT的4 898例孕妇作为研究对象,并按照孕前BMI水平分为轻体质量(BMI<18.5kg/m2)、正常体质量(BMI 18.5~23.9kg/m2)、超重(BMI 24.0~27.9kg/m2)和肥胖(BMI≥18.5kg/m2)4组,比较不同孕前BMI水平孕妇75g OGTT血糖值,计算GDM的检出率,分析不同孕前BMI水平与GDM检出率的相关关系。结果 GDM检出率为22.5%(1 102/4 898),轻体质量、正常体质量、超重、肥胖4组GDM检出率分别为:13.3%、20.7%、31.6%、39.2%,随着孕前BMI的上升,GDM的检出率也呈明显上升趋势(χ趋势2=110.175,P<0.001)。轻体质量、正常体质量、超重、肥胖各组孕妇随着孕前BMI的上升,OGTT不同时点(空腹OGTT、OGTT 1h、OGTT 2h)血糖值均呈明显上升趋势(F值分别为92.835、64.455、36.855,均P<0.05);超重组与肥胖组孕妇不同时点(空腹OGTT、OGTT 1h、OGTT 2h)血糖值比较差异均无统计学意义(t值分别为-1.721、-1.316、-0.365,均P>0.05),但这两组孕妇不同时点(空腹OGTT、OGTT 1h、OGTT 2h)血糖值分别与轻体质量组和正常体质量组比较,差异均有统计学意义(超重组与轻体质量组、正常体质量组比较:t值分别为14.075、14.583、9.769、13.650、9.990、6.743,均P<0.05;肥胖组与轻体质量组、正常体质量组比较:t值分别为16.214、15.321、10.187、14.110、10.152、7.589,均P<0.05)。孕前BMI值与血糖异常分组之间存在相关性(r=0.307,P=0.018),孕前BMI值与GDM检出率之间亦存在相关性(r=0.362,P<0.001)。结论随着孕前BMI的增加,孕妇GDM的检出率和OGTT有2项及以上异常者所占比例也相应增加。对于孕前体质量超重或肥胖的孕妇,更应当关注其GDM的发病风险。
Objective To investigate the characteristics of oral glucose tolerance test(OGTT) in pregnant women with different pre-pregnancy body mass index(BMI) and to analyze the relationship between different pre-pregnancy BMI and detection rate of gestational diabetes mellitus(GDM). Methods A total of 4 898 pregnant women who delivered and received 75 g OGTT in Haikou Hospital of Maternal and Child Health Care between January 2015 and December 2017 were collected as study objects and were divided into underweight(BMI<18.5 kg/m2), normal weight(BMI: 18.5-23.9 kg/m2), overweight(BMI: 24.0-27.9 kg/m2) and obesity(BMI≥18.5 kg/m2) groups based on pre-pregnancy BMI. The 75 g OGTT blood glucose values of pregnant women with different pre-pregnancy BMI levels were compared, and detection rate of GDM was calculated. Correlation between pre-pregnancy BMI levels and detection rate of GDM was analyzed. Results Total GDM detection rate was 22.5%(1 102/4 898), and detection rates in underweight, normal weight, overweight and obesity groups were 13.3%, 20.7%, 31.6%, and 39.2% respectively. Along with rising of pre-pregnancy BMI, detection rate of GDM showed a significant upward trend(χtrend2=110.175, P<0.001). With increase of pre-pregnancy BMI, blood glucose values of OGTT at different time points(fasting OGTT, OGTT 1 h, OGTT 2 h) in underweight, normal weight, overweight and obesity groups showed a significant upward trend(F value was 92.835, 64.455 and 36.855, respectively, all P<0.05). There was no significant difference in blood glucose levels at different time points(fasting OGTT, OGTT 1 h, OGTT 2 h) between overweight group and obese group(t value was-1.721,-1.316 and-0.365, respectively, all P>0.05). There were significant differences in blood glucose values at different time points(fasting OGTT, OGTT 1 h, OGTT 2 h) between overweight group, obesity group and underweight group, normal weight group(comparison between overweight group and underweight, normal weight groups, t value was 14.075, 14.583, 9.769, 13.650, 9.990 and 6
作者
林曼
许莉
卢秀英
孙明霞
王秀妹
LIN Man;XU Li;LU Xiuying;SUN Mingxia;WANG Xiumei(Department of Obstetrics and Gynecology,Haikou Hospital of Maternal and Child Health Care,Hainan Haikou 570102,China)
出处
《中国妇幼健康研究》
2019年第5期581-584,共4页
Chinese Journal of Woman and Child Health Research
关键词
身体质量指数
妊娠期糖尿病
葡萄糖耐量试验
相关性
body mass index (BMI)
gestational diabetes mellitus (GDM)
oral glucose tolerance test (OGTT)
correlation
