妊娠期糖尿病患者BMI与同型半胱氨酸、妊娠结局的关联性分析

Relationship between BMI and Homocysteine,Pregnancy Outcomes in Patients with Gestational Diabetes Mellitu

目的探讨妊娠期糖尿病患者身体体重指数(body mass index,BMI)与同型半胱氨酸和妊娠结局的关联性。方法自2015年1月~2016年10月,前瞻性收集妊娠期糖尿病患者120例,根据患者BMI水平,将患者分为肥胖组(BMI≥25kg/m^2)和对照组(<25kg/m^2)。主要观察指标包括两组患者同型半胱氨酸和妊娠结局。结果与对照组比较,肥胖组孕妇孕12周时同型半胱氨酸显著增加(11.09±1.91 vs 8.92±1.57μmol/L,P=0.000);BMI与同型半胱氨酸呈正相关(r=0.410,P=0.000)。与对照组比较,肥胖组剖宫产率显著增加(30.00%vs 15.00%,P=0.049);巨大儿发生率显著增加(20.00%vs 5.00%,P=0.027);新生儿体重显著增加(3672.15±475.45 vs 3220.93±461.36g,P=0.000)。两组患者妊娠周数、产后出血、头盆不称、胎位异常、宫缩乏力、胎膜早破和新生儿窒息发生率等比较,差异无统计学意义(P>0.05)。结论妊娠期糖尿病患者BMI与同型半胱氨酸、剖宫产、巨大儿和新生儿体重呈正相关。

Objective To investigate the relationship between body mass index （BMI） and homocysteine, pregnancy outcomes in patients with gestational diabetes mellitus. Methods From Jan, 2013 to Oct, 2015, 120 patients with gestational diabetes mellitus were prospectively enrolled in this study. According to BMI level, all patients were divided into obese group （BMI ≥ 25 kg/m^2） and the control group （BMI〈25kg/m^2）. The main outcome measures included homocysteine and pregnancy outcomes of the both groups. Results When compared with the control group, patients in the obese group got a significantly higher level of homocysteine （11.09±1.91 vs 8.92±1.57μmol/L,P=0.000）; and BMI was positively associated with homocysteine （r=0.410, P=0.000）. When compared with the control group, patients in the obesity group got a significantly higher rate of cesarean section （30.00% vs 15%, P=0.049）; a higher rate of macrosomia （20.00% vs 5.00%, P=0.027）; and a higher level of neonatal weight （3672.15±475.45 vs 3220.93±461.36g, P=0.000）. There was no significantly difference between the two groups in weeks of gestation, postpartum hemorrhage, cephalopelvic said, abnormal fetal position, uterine atony, premature rupture of fetal membranes and neonatal asphyxia rate （P〉0.05）. Conclusion BMI in patients with gestational diabetes mellitus is positively correlated with homocysteine, cesarean section, macrosomia and neonatal weight.