摘要
目的 探究多囊卵巢综合征(PCOS)孕妇发生妊娠期糖尿病(GDM)的危险因素。方法 回顾性分析2015年1月至2020年12月在北京市通州区妇幼保健院建档并住院分娩的337例PCOS孕妇的临床资料,根据是否合并GDM分为PCOS组221例,GDM组116例。比较两组的年龄、文化程度、妊娠方式、孕产次、糖尿病家族史、孕前体质量指数(BMI)、孕早期糖化血红蛋白(HbA1c)、糖化白蛋白及血生化指标等。结果 GDM组孕前BMI(25.58±4.27)kg∕m^(2)比(23.22±3.54)kg∕m^(2)、孕早期HbA1c(5.277±0.301)%比(5.095±0.290)%、空腹血糖(FPG)(5.286±0.379)mmol/L比(5.006±0.330)mmol/L、均明显高于PCOS组,差异有统计学意义(P<0.05)。logistic回归分析提示孕前BMI[OR=1.13,95%CI:(1.05,1.20)]、孕早期HbA1c[OR=2.76,95%CI:(1.10,6.95)]、FPG[OR=6.86,95%CI:(3.19,14.77)]是GDM发生的独立危险因素。经受试者操作特征(ROC)曲线分析,孕前BMI、孕早期HbA1c、FPG单项及三者联合预测GDM的曲线下面积(AUC)分别为0.67、0.68、0.72、0.78,三者联合对GDM的预测价值最高。孕前BMI、孕早期HbA1c、FPG预测GDM的截点值分别为23.98 kg/m^(2)、5.15%、5.14 mmol/L。结论PCOS孕妇孕前BMI、孕早期HbA1c和FPG较高时,容易发生GDM。建议PCOS女性孕前适当减重,孕早期监测并控制HbA1c和FPG在适当范围,以期减少GDM的发生。
Objective To explore the risk factors for gestational diabetes mellitus(GDM)in pregnant women with polycystic ovary syndrome(PCOS).Methods The clinical data of 337 pregnant women with PCOS who were recorded and delivered inpatiently at Tongzhou District Maternal and Child Health Hospital in Beijing from January 2015 to December 2020 were retrospectively analyzed,and were divided into the PCOS group(221 cases)and the GDM group(116 cases)according to whether they had GDM in combination.Age,education,pregnancy type,pregnancy and delivery,family history of diabetes,prepregnancy body mass index(BMI),early pregnancy glycated hemoglobin(HbA1c),glycated albumin and blood biochemical indexes were compared between the two groups.Re⁃sults The prepregnancy BMI(25.58±4.27)kg∕m^(2) vs.(23.22±3.54)kg∕m^(2),HbA1c(5.277±0.301)%vs.(5.095±0.290)%and fasting plasma glucose(FPG)(5.286±0.379)mmol/L vs.(5.006±0.330)mmol/L were significantly higher than those in the PCOS group,with statistically significant differences(P<0.05).Logistic regression analysis indicated that prepregnancy BMI[OR=1.13,95%CI:(1.05,1.20)],HbA1c[OR=2.76,95%CI:(1.10,6.95)]and FPG[OR=6.86,95%CI:(3.19,14.77)]were independent risk factors for the development of GDM.By receiver operating characteristic(ROC)curve analysis,the area under the curve(AUC)of prepregnancy BMI,early pregnancy HbA1c,and FPG alone and the combination of the three predicted GDM were 0.67,0.68,0.72,and 0.78,respectively,and the combination of the three had the highest predictive value for GDM.The cutoff values of prepregnancy BMI,early pregnancy HbA1c,and FPG for predicting GDM were 23.98 kg/m^(2),5.15%,and 5.14 mmol/L,respectively.Conclusions Pregnant women with PCOS are prone to GDM when their prepregnancy BMI,early pregnancy HbA1c and FPG are high.It is recommended that women with PCOS lose weight appropriately before pregnancy and monitor and control HbA1c and FPG in the appropriate range in early pregnancy to reduce the occurrence of GDM.
作者
卢永军
赵志玲
焦钰洁
冯爱迪
LU Yongjun;ZHAO Zhiling;JIAO Yujie;FENG Aidi(Department of Obstetrics and Gynecology,Tongzhou Maternal and Child Health Care Hospital of Beijing,Beijing 101100,China)
出处
《安徽医药》
CAS
2023年第6期1188-1191,共4页
Anhui Medical and Pharmaceutical Journal
基金
中国疾病预防控制中心妇幼保健中心母婴营养与健康研究项目资助(2021FY017)。
关键词
多囊卵巢综合征
危险因素
妊娠期糖尿病
孕前体质量指数
糖化血红蛋白
空腹血糖
Polycystic ovary syndrome
Risk factors
Gestational diabetes mellitus
Prepregnancy body mass index
Glycated hemoglobin
Fasting blood glucose
