妊娠期糖尿病患者产后代谢指标的变化及影响因素分析

Changes in Postpartum Metabolic Indexes and Their Influencing Factors in Patients with Gestational Diabetes Mellitus

目的探讨妊娠期糖尿病患者产后代谢指标的变化及影响因素。方法选择妊娠期糖尿病患者(观察组)113例和行孕期检查的健康孕妇(对照组)111例。回顾性分析2组的临床资料。对妊娠期糖尿病患者产后代谢指标变化的影响因素进行统计学分析。结果观察组孕次、孕中期血清hs-CRP水平,糖尿病家族史(是、否)比例及产后1年血清2hPPG、TG、LDL-C水平,血清FPG≥5.6mmol·L-1、TG≥1.70mmol·L-1和葡萄糖耐量受损、舒张压≥85mm Hg、腰围>80cm比例与对照组比较差异均有统计学意义(均P<0.05)。有糖尿病家族史(OR=1.064,95%CI1.052~1.113,P<0.05)、孕中期血清hs-CRP水平(OR=1.013,95%CI 1.023~1.032,P<0.05)、产后1年腰围>80cm(OR=0.045,95%CI0.034~0.077,P<0.05)均是妊娠期糖尿病患者产后代谢指标变化的影响因素。结论妊娠期糖尿病患者存在产后代谢指标异常,有糖尿病家族史、孕中期血清hs-CRP水平、产后1年腰围>80cm均是妊娠期糖尿病患者产后代谢指标变化的影响因素,临床上应定期对患者进行相应指标的检测。

Objective To investigate the changes in postpartum metabolic indexes and their influencing factors in patients with gestational diabetes mellitus.Methods Clinical data of 113 patients with gestational diabetes mellitus(observation group)and 111 healthy pregnant women(control group)were analyzed retrospectively.The factors influencing postpartum metabolic indexes were analyzed statistically.Results There were significant differences between the two groups in the gravidity,midtrimester serum hs-CRP levels,percentage of patients with family history of diabetes(yes or no),1-year postpartum serum 2hPPG,TG and LDL-C levels,and proportions of serum FPG≥5.6 mmol·L^(-1),TG≥1.70 mmol·L-1,impaired glucose tolerance,diastolic blood pressure≥85mmHg and waist circumference>80cm(P<0.05).The factors influencing postpartum metabolic indexes included family history of diabetes(OR=1.064,95%CI1.052-1.113,P<0.05),midtrimester serum hs-CRP levels(OR=1.013,95%CI 1.023~1.032,P<0.05),and 1-year postpartum waist circumference>80cm(OR=0.045,95%CI 0.034~0.077,P<0.05).Conclusion Patients with gestational diabetes mellitus have postpartum metabolic disorders.The family history of diabetes,midtrimester serum hs-CRP levels and 1-year postpartum waist circumference>80cm are the factors influencing postpartum metabolic indexes.Therefore,the corresponding indicators should be detected regularly in pregnant women.