妊娠前TyG指数与妊娠期糖尿病及巨大儿的关系

RELATIONSHIP BETWEEN PREPREGNANCY TYG INDEX AND GESTATIONAL DIABETES MELLITUS AND LARGE-FOR-GESTATIONAL AGE

目的探讨妊娠前空腹血清甘油三酯和血浆葡萄糖所得简易指数(TyG)对妊娠期糖尿病(GDM)以及巨大儿(LGA)的影响。方法采用前瞻性队列研究方法,以参加2006—2017年开滦职工健康体检并在体检后住院分娩的育龄妇女为观察队列,最终纳入调查对象1118例。采用卡方检验比较妊娠前TyG分组间GDM患病率及发病风险的差异;以是否发生GDM为因变量,以妊娠前TyG为自变量,采用多因素Logistic回归分析妊娠前TyG对GDM的影响。采用卡方检验分别比较妊娠前TyG分组间LGA患病率及发病风险的差异;以是否发生LGA为因变量,以妊娠前TyG为自变量,采用多因素Logistic回归分析妊娠前TyG对LGA的影响。结果GDM的患病率为14.2%,TyG水平较高组GDM患病率较高,组间差异有统计学意义(P<0.05)。TyG高水平组患GDM危险性是TyG低水平组的1.59倍,二者之间的关系有统计学意义(95%CI:1.10~2.29)。多因素Logistic回归分析显示,妊娠前TyG水平较高是GDM的危险因素(OR=1.45,95%CI:1.00~2.11,P<0.05)。LGA的患病率为15.5%,TyG高水平组患LGA危险性是低水平组的1.49倍,二者之间的差异有统计学意义(95%CI:1.06~2.10),多因素Logistic回归分析显示,妊娠前TyG不是GDM的危险因素。结论妊娠前TyG增高是GDM及LGA的危险因素。

Objective To investigate the effect of Triglyceride-glucose index(TyG)before pregnancy on gestational diabetes mellitus(GDM)and large-for-gestational age(LGA).Methods A prospective cohort study was used to study the effect of pre pregnancy TyG on GDM and LGA in one thousand one hundred and eighteen pregnant women of childbearing age who were enrolled in the 2006~2017 health examination(n=1118).according to the level of TyG before pregnancy,the pregnant women were divided into three groups,and the effects of TyG on GDM and LGA were analyzed by logistic regression.Results The prevalence of GDM and LGA was 14.2%and 15.5%.Univariate and multivariate logistic regression analysis showed that the third trimester of TyG before pregnancy was the risk factor of GDM(OR=1.45,95%CI:1.00~2.11,P<0.05).Multivariate logistic regression analysis showed that TyG before pregnancy was not a risk factor for LGA.Conclusion Increased TyG before pregnancy is the risk factor for GDM,and increased TyG before pregnancy is not the risk factor of LGA,