妊娠期糖尿病患者发病的影响因素探讨

Influence factors of onset in patients with gestational diabetes

目的探讨引发妊娠期糖尿病(GDM)发病的危险因素,为临床的预防和治疗提供参考。方法采用病例对照研究方法,选取2012年1月至2014年12月海南省保亭黎族苗族自治县人民医院收治的GDM患者98例作为观察组,另选同期健康体检孕妇98例作为对照组,采用单因素和多因素非条件Logistic回归分析筛选引发GDM的危险因素。结果单因素结果显示,年龄大于或等于35岁、孕前体质量指数(BMI)、糖尿病家族史、三酰甘油水平、孕期体质量增长、不良孕产史、空腹血糖水平、空腹胰岛素水平、胰岛素抵抗指数为GDM相关危险因素(P<0.05);而与总胆固醇水平、高密度脂蛋白水平、低密度脂蛋白水平差异无统计学意义(P>0.05);多因素非条件Logistic回归分析结果显示,年龄大于或等于35岁、孕前BMI、糖尿病家族史、三酰甘油水平、空腹血糖、空腹胰岛素是引发GDM的独立危险因素(P<0.05)。结论年龄、糖尿病家族史等因素在GDM发生和发展中具有重要作用,因此孕妇要密切注意引发GDM的相关危险因素和适时监测血糖,加强早孕期GDM筛查和防治,减少和阻止GDM发生。

Objective To explore the risk factors inducing the onset of gestational diabetes mellitus（GDM ） so as to provide reference for clinical prevention and treatment .Methods By adopting the case‐control study method ,98 cases of GDM in the People′s Hospital of Baoting Li and Miao Autonomous County from January 2012 to December 2014 were selected as the observation group and contemporaneous 98 healthy pregnant women as the control group . The single factor and multiple factors unconditioned Logistic regression analysis were adopted to screen the risk fac‐tors causing the onset of GDM .Results The single factor analysis results showed that the age of over 35 years old , pre‐pregnant BMI ,family history of diabetes ,triglyceride levels ,weight gain during pregnancy ,abnormal gestation and birth history ,fasting glucose ,fasting insulin levels and insulin resistance index were the GDM related risk factors （P〈0 .05） ;The differences in total cholesterol ,high‐density lipoprotein（HDL） and low density lipoprotein（LDL ） levels had no statistical significance（P〉0 .05） ;the multi‐factor unconditioned Logistic regression analysis showed that age over 35 years old ,pre‐pregnant BMI ,family history of diabetes ,triglyceride levels ,fasting glucose and fasting insulin were the independent risk factors inducing GDM （P〈 0 .05） .Conclusion The factors of age ,family history , etc .play an important role in the occurrence and development of GDM ,so pregnant women should closely pay atten‐tion to the related risk factors causing GDM and timely monitor blood sugar ,enhance early pregnancy GDM screen‐ing ,and reduce and prevent the occurrence of GDM .