孕早期血红蛋白水平与妊娠期糖尿病的关联性

Study on the relationship between maternal hemoglobin concentration and the risk of gestational diabetes mellitus

目的：探讨孕早期血红蛋白（Hb）与妊娠期糖尿病（GDM）发病风险间的关系。方法：应用病例对照研究设计，对109例GDM孕妇（GDM组）和151例健康孕妇（对照组）的临床资料进行分析。结果：单因素分析显示GDM组孕妇年龄、孕前体质量指数（BMI）、孕早期Hb浓度、孕早期收缩压、孕早期舒张压、文化水平、孕次、产次均明显高于对照组（P〈0．05）。将孕早期Hb浓度按四分位间距分为四组，比较各四分位和GDM组发病的关系，发现Hb浓度升高，GDM发生风险增加；spearman相关分析示孕早期Hb浓度与GDM的发生呈正相关（r=0．201，P=0．001）。在校正了可能的混杂因素后，多元loglstic回归分析结果显示，孕早期高Hb水平（Hb〉130g／L）可显著增加GDM的发生风险（OR=3．54，95％CI：1．60～7．83，P=-0．002）。结论：孕早期高Hb浓度将增加GDM的发病风险，应加强对孕早期妇女血Hb水平的监测，为有效预测及预防GDM的发生提供依据。

Objective： To explore the relationship between maternal hemoglobin concentration （Hb） in earlypregnancy and the incidence of gestational diabetes mellitus （GDM）. Methods： In a case-controlled study, the clinical date of 109 women with GDM （GDM group） and 151 healthy pregnant women （control group） were analyzed retrospectively. Results： The univariate analysis revealed that the age, body mass index （BMI） before pregnancy, high Hb concentration at early pregnancy, systolic pressure and diastolic pressure at early pregnancy, educational level, gravidity and parity in the GDM group were higher than that in the control group （P〈0.05）. The subjects were divided into 4 quartiles in order of increasing Hb concentration level, among which Hb concentration and the incidence of GDM were compared. With the Hb concentration increasing the risk of GDM increased. A positive correlation was found between Hb concentration and the incidence of GDM by the spearman rank correlation （r=-0.201, P=0.001）. Multivariate logistic regression analysis revealed that, with adjustment for the confounding factor above-mentioned, high Hb concentration （Hb 〉 130 g/L） at early pregnancy had an increased risk of GDM （OR=3.54, 95%CI： 1.60 - 7.83, P=0.002）. Conclusion： High Hb concentration at early pregnancy increases the incidence of GDM, Hb examining can be effective measure of screening for GDM.