妊娠期糖尿病患者OGTT试验不同时点血糖值异常的影响因素

Influencing factors of abnormal blood glucose values at different time points in OGTT among gestational diabetes mellitus patients

目的探讨妊娠期糖尿病患者口服葡萄糖耐量试验(OGTT)后所得不同时间点血糖值异常的影响因素。方法依据国际妊娠合并糖尿病研究组织(IADPSG)妊娠期糖尿病诊断标准,随机选取孕期在24~28周范围内行75 g OGTT试验的孕妇102例,依据不同时点血糖值的异常情况分组。A组:单纯空腹血糖异常;B组:单纯餐后血糖异常;C组:空腹或餐后血糖异常;D组:3项血糖均异常。同时以问卷形式进行妊娠期糖尿病患者基本资料及营养知识态度行为知晓率的调查。采用χ~2检验及多项Logistic回归进行影响因素分析。结果 4组人数构成比比较,差异有统计学意义(χ~2=8.000,P<0.05)。单因素分析结果显示,A组年龄、孕前体质量指数(BMI)、孕次、职业、平均月收入及家族史因素比较,差异有统计学意义(P<0.05);B组孕前BMI、孕次、既往史、家族史因素比较,差异有统计学意义(P<0.05);C组孕前BMI、平均月收入、既往史及家族史因素比较,差异有统计学意义(P<0.05);D组孕次、平均月收入、既往史因素比较,差异有统计学意义(P<0.05)。多因素分析结果显示,年龄、孕前BMI、不良孕史、居住地、学历、既往史、平均月收入、家族史因素比较,差异具有统计学意义(P<0.05)。总体被调查者对妊娠期糖尿病营养知识态度行为的知晓率较低,仅为29.4%。结论孕前BMI、孕次、既往史、家族史、年龄、职业及平均月收入是不同时点血糖值异常的主要影响因素。此外,妊娠期糖尿病妇女营养知识态度行为知晓率较低,对妊娠期糖尿病的危害认识不够。

Objective To explore the influencing factors of abnormal blood glucose values at different time points in oral glucose tolerance test（OGTT） among gestational diabetes mellitus（GDM） patients.Methods According to IADPSG diagnostic criteria of GDM,102 pregnant women receiving 75 g OGTT within 24-28 gestational weeks were randomly selected and divided into four groups according to abnormal blood glucose values at different time points：group A（abnormal fasting blood glucose level）,group B（abnormal postprandial blood glucose level）,group C（abnormal fasting or postprandial blood glucose level）,and group D（abnormal three blood glucose values）.A questionnaire was used to survey the basic information of GDM patients and awareness rate of nutritional knowledge,attitude,and practice.χ~2 test and multivariate logistic regression model were used to analyze the influencing factors.Results There was statistically significant difference in the proportion of patients among the four groups（χ~2= 8.000,P〈0.05）.Univariate analysis showed that there were statistically significant differences in age,progestational body mass index（BMI）,gravidity,occupation,mean monthly income,and family history in group A（P〈0.05）;there were statistically significant differences in progestational BMI,gravidity,previous history,and family history in group B（P〈0.05）;there were statistically significant differences in progestational BMI,mean monthly income,previous history,and family history in group C（P〈0.05）;there were statistically significant differences in gravidity,mean monthly income,and previous history in group D（P〈0.05）.Multivariate analysis showed that there were statistically significant differences in age,progestational BMI,adverse pregnancy history,residence,educational background,previous history,mean monthly income,and family history（P〈0.05）.The awareness rate of nutritional knowledge,attitude,and practice among the GDM patients was low,which was only 29.4%.Conclusion Progestational BMI,gravidity,previous history,family history,age,occupation,and mean monthly income are main influencing factors of abnormal blood glucose values at different time points in OGTT.The awareness rate of nutritional knowledge,attitude,and practice among the GDM patients is low,and their cognition of harms of GDM is not enough.