年龄对妊娠期糖尿病发病风险影响的调查研究

An Investigation Study of Ages on Risk of Gestational Diabetes Mellitus in Pregnant Women

目的调查分析孕妇年龄对妊娠期糖尿病（gestational diabetes mellitus,GDM）发病的影响。方法对21371例2007—2015年在解放军306医院妇产科分娩,且在妊娠24-32周行一步法75 g葡萄糖耐量试验（OGTT）的初产单活胎孕妇的年龄及糖代谢情况进行回顾性调查分析。根据OGTT结果将孕妇分为非妊娠期糖尿病组（NGDM组）和妊娠期糖尿病组（GDM组）,评估怀孕年龄与OGTT血糖水平的关系及对GDM患病的影响。结果 GDM患者2577例,其发病率为12.1%。GDM在-20岁、-25岁、-30岁、-35岁、-40岁及-45岁的发病率分别为0、5.1%、7.5%、13.5%、30.4%及68.5%。GDM组孕妇年龄（33.28±5.36）岁显著高于NGDM组孕妇的（29.67±3.58）岁（P〈0.01）。2007-2015年,GDM孕妇平均年龄由（32.57±5.52）岁增加至（34.57±4.95）岁。所有孕妇及NGDM组峰值年龄均在29岁,而GDM组峰值年龄在31岁。随妊娠年龄的增加,NGDM组和GDM组孕妇OGTT的0 min、60 min和120 min血糖均呈上升趋势。结论近年来GDM患病率较高,孕妇年龄逐年增高是重要原因,同时,GDM在30岁以下孕妇中有较高患病比例值得密切关注。

Objective To investigate effect of age on pathogenesy of gestational diabetes mellitus （GDM） in pregnant women. Methods Conditions of age and glycometabolism of 21371 pregnant women, who were given primipari-ty and a single live birth from 2007 to 2015 labor and receiving one-step 75 g oral glucose tolerance test （ OGTT） during 24-32 gestational weeks were retrospectively analyzed. The patients were divided into non GDM （ NGDM ） and GDM groups according to OGTT results, and relationship between pregnant age and glucose levels was evaluated, and effect of pregnant age on pathogenesy of GDM was also analyzed. Results There were 2577 GDM patients, and prevalence rate was 12. 1%. GDM prevalence rate respectively were 0, 5. 1%, 7. 5%, 13. 5%, 30. 4% and 68. 5% when pregnant a-ges were less than 20 years old, 20-25 years old, 26-30 years old, 30-35 years old, 36-40 years old and more than 45 years old. Average age of pregnant women in GDM group （33. 28 ± 5. 36 years old） was significantly higher than （29.67 ±3.58） years old in NGDM group （P 〈0. 01）. During 2007 to 2015 years, average age of GDM pregnant women increased from （32. 57 ± 5. 52） years old to （34. 57 ± 4. 95） years old. Ages of NGDM peak and all pregnant women were 29 years old, while GDM peak age was 31 years old. OGTT results at the time of fasting, 60 and 120 min af-ter OGTT were increased with increased pregnant age in NGDM and GDM groups. Conclusion In recent years, in-creased pregnant age may pay an important role to the high prevalence rate of GDM. It is necessary to pay more attention to the high prevalence rate of GDM in pregnancy women less than 30 years old simultaneously.