糖尿病孕妇血清晚期糖基化终产物水平与新生儿心血管功能异常的关系

Relationship between Serum Advanced Glycation End Products Levels of Diabetic Mothers and Adverse Cardiovascular Function of Newborn Infants

目的探讨妊娠期糖尿病孕妇(GDM)血清晚期糖基化终产物(AGEs)水平与新生儿心血管功能异常的关系。方法选择符合入选条件的妊娠中期GDM60例,妊娠晚期GDM72例。同期产科检查正常的妊娠中期孕妇72例,妊娠晚期孕妇80例。检测各组孕妇空腹血糖值、血清AGEs水平。收集GDM及其新生儿临床资料,根据新生儿心血管功能异常与否分为新生儿正常组和新生儿异常组,比较不同孕期2组孕妇血清AGEs、血糖水平的改变,以及2组新生儿的母亲血清AGEs水平。分析GDM新生儿心血管功能异常的危险因素。结果 1.无论妊娠中期还是妊娠晚期,GDM组孕妇血清AGEs水平、空腹血糖值均明显高于正常孕妇组(Pa<0.001,0.05)。2.同一GDM经干预治疗妊娠晚期时血糖明显降低(P<0.05);血清AGEs水平仍保持较高水平,妊娠中期与妊娠晚期比较差异无统计学意义(P>0.05)。3.新生儿异常组母亲血清AGEs水平明显高于新生儿正常组(P<0.05)。4.Logistic回归分析显示AGEs是GDM新生儿心血管功能异常的危险因子(OR=6.285,P<0.001,95%CI:2.561～15.524)。结论高AGEs血症是GDM新生儿心血管功能异常的危险因素之一,妊娠中晚期持续高水平AGEs可能是新生儿心血管功能异常发病率较高的原因之一。

Objective To explore the relationship between serum advanced glycation end products（AGEs） levels in gestation diabetic mother（GDM） and cardiovascular function of newborn infants.Methods Sixty mid-gestation GDM and 72 late-gestation GDM fulfilling the inclusion criteria were recruited,72 mid-gestation and 80 late-gestation mothers with no pregnancy complications were collected as controls.Fasting blood glucose and serum AGEs levels were analyzed in each group.Clinical data of GDM and their babys were collected.Accor-ding to cardiovascular function of neonates,these neonates were divided into 2 groups：normal neonate group with normal cardiovascular function and anormal neonate group with anormal cardiovascular function.Maternal serum AGEs levels,blood glucose between mid-gestation groups and late-gestation groups were compared.Factors which affected the prevalence of complications of fetal outcome in GDM were analyzed.Results 1.Mid-gestation and late-gestation GDM groups had higher serum AGEs levels and fasting blood glucose compared with those of their respective controls（Pa0.001,0.05）.2.After treatment,mid-gestation GDM had significantly lower blood glucose level at late-gestation（P0.05）,but their serum AGEs levels remained relatively high,there was no significant change in serum AGEs levels from mid-gestation to late-gestation（P0.05）.3.Abnormal fetal outcome in GDM had significantly higher maternal serum AGEs levels than that in controls with normal fetal outcome（P0.05）.4.Logistic regression analysis showed that AGEs was a predictor of adverse perinatal outcome in GDM（OR=6.285,P0.001;95% CI： 2.561-15.524）.Conclusions High serum AGEs is an adverse factor for perinatal outcome in GDM,sustained high AGEs levels from mid-gestation to late-gestation can be an indicator of adverse perinatal outcome.