摘要
目的 探讨孕早期三酰甘油(TG)、空腹血糖(FPG)及三酰甘油葡萄糖乘积指数(TyG)与妊娠期高血压疾病的关系,为妊娠期高血压疾病的防治提供基础数据。方法 以舟山市孕妇队列中符合研究标准的1 110例孕妇作为研究对象,采用广义估计方程(GEE)分析TG、FPG及TyG对孕妇收缩压、舒张压及平均动脉压的影响,采用受试者工作特征曲线(ROC)和曲线下面积(AUC)评价3种指标对妊娠期高血压疾病高危孕妇的预测价值。结果 高危组孕妇TG[(1.63±0.63) mmol/L]、FPG[(4.90±0.49) mmol/L]及TyG(8.69±0.37)均显著高于对照组[(1.53±0.61) mmol/L、(4.82±0.46)mmol/L及(8.61±0.37)]。GEE模型的分析结果显示:TyG(β=1.34,P<0.05)和TG水平(β=0.73,P<0.05)与孕妇收缩压存在显著关联,但FPG水平(β=-0.02,P>0.05)与收压缩无关。并且孕妇TyG和TG水平与收缩压的关联均呈剂量反应关系,当TyG每升高1个单位时,孕妇的收缩压上升1.11 mm Hg;当TG水平每升高1个单位时,孕妇的收缩压上升1.24 mm Hg。TG、FPG及TyG与舒张压间的关联则与收缩压相反,孕妇的舒张压仅与FPG水平存在显著关联(β=0.66,P<0.05),且不存在剂量反应关系。TyG与平均动脉压存在显著关联(β=1.02,P<0.05);当TG水平较高时,其与平均动脉压存在关联(Q3:β=1.04,P<0.05;Q4:β=0.89,P<0.05)。ROC曲线分析结果显示,孕早期TG、FPG及TyG筛查对妊娠期高血压疾病发病风险均可起到预测作用,调整孕妇的基本情况和产检信息等协变量后,TG、FPG及TyG的曲线下面积分别为0.677、0.678及0.680。结论 孕早期较高的TG、FPG及TyG水平是妊娠期高血压疾病发病的独立危险因素,孕早期行TG、FPG及TyG筛查对妊娠期高血压疾病发病风险具有预测价值,在妊娠期高血压疾病防治中应予以重视。
Objective To explore the associations between triglyceride(TG), fasting blood glucose(FPG) and triglyceride-glucose index(TyG) in the first trimester of pregnancy and gestational hypertension, and provide theoretical basis for the prevention of gestational hypertension.Methods The cohort study of pregnant women enrolled in Zhoushan, Zhejiang, included 1 110 participants from the Zhoushan Pregnant Women Cohort. Generalized estimating equations(GEE) were used to analyze the effects of TG, FPG and TyG on systolic blood pressure, diastolic blood pressure and mean arterial pressure. The receiver operating characteristic(ROC) curve and area under curve(AUC) were used to evaluate the predictive value of the three indicators for pregnant women with high risk of gestational hypertension.Results The levels of TG, FPG and TyG in the high-risk group were(1.63±0.63) mmol/L,(4.90±0.49) mmol/L and(8.69±0.37), respectively, which were significantly higher than those in the control group [TG:( 1.53±0.61) mmol/L;FPG:(4.82±0.46) mmol/L;TyG:(8.61±0.37)]. The results of GEE models showed that TyG(β=1.34,P<0.05) and TG(β=0.73, P<0.05) were significantly associated with systolic blood pressure, while FPG(β=-0.02,P>0.05) was not associated with systolic blood pressure. And the relationship between TyG or TG and systolic blood pressure were dose response. The level of systolic blood pressure increased 1.11 mm Hg or 1.24 mmHg respectively with increments of one unit of TyG or TG. The associations between TG, FPG and TyG and diastolic blood pressure were opposite to that of systolic blood pressure. The diastolic blood pressure was only significantly related to FPG(β=0.66,P<0.05), and there was no dose-response relationship. TyG was significantly associated with mean arterial pressure(β=1.02,P<0.05), and TG was associated with mean arterial pressure(Q3: β=1.04,P<0.05;Q4: β=0.89,P<0.05) only when the level was high. The results of ROC curve showed that the detection of TG, FPG and TyG in the first trimester could all predict the
作者
徐娟
吴金华
蒲柳艳
黄满仙
陈文艳
程昊悦
斯淑婷
余运贤
XU Juan;WU Jin-Hua;PU Liu-Yan(Zhoushan Women and Children's Hospital,Zhoushan,Zhejiang 316000,China)
出处
《中国妇幼保健》
CAS
2022年第23期4339-4344,共6页
Maternal and Child Health Care of China
基金
浙江省医药卫生科研基金项目(2015RCA026)
浙江省舟山市科技计划项目(2022C31017)
浙江省舟山市医药卫生科研基金项目(2022YA19)。
