A2型妊娠期糖尿病与血脂代谢水平相关性分析

Correlation analysis between type A2 gestational diabetes mellitus and lipid metabolism level

目的:观察妊娠期糖尿病(GDM)孕妇与正常孕妇血脂的差异,探讨妊娠中晚期血脂与A2型GDM的相关性。方法:对GDM孕妇根据是否使用胰岛素控制血糖的分为观察组A1(53例)、观察组A2(43例),正常孕妇49例为对照组。比较对照组、观察组A1及观察组A2孕妇妊娠中晚期总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白a、载脂蛋白A1(ApoA1)和载脂蛋白B(ApoB)的水平,并分析血脂与A2型GDM的相关性。结果:观察组A2孕中期的TG、HDL-C、Apo A1、脂蛋白a及孕晚期的TC、TG、HDL-C、Apo A1与对照组比较差异有统计学意义(P<0.05~P<0.01),观察组A1孕中期的HDL-C、Apo A1、脂蛋白a及孕晚期的ApoA1、HDL-C与观察组A2比较差异有统计学意义(P<0.01)。logistic回归分析,孕中期ApoA1、孕晚期TC及孕晚期HDL-C与A2型GDM密切相关,ROC曲线分析在三者联合预测孕期发生A2型GDM的中,曲线下面积为0.869,95%CI为0.795~0.943,具有较高预测可信度(P<0.05)。结论:孕中期ApoA1、孕晚期TC及孕晚期HDL-C与孕期A2型GDM的发生发展相关。

Objective:To investigate the difference of the blood lipid level between pregnant women with gestational diabetes mellitus(GDM)and normal pregnant women,and explore the correlation between blood lipid level in middle and late pregnancy and type A2 GDM.Methods:The patients with GDM were divided into the A1 experimental group(53 cases)and A2 experimental group(43 cases)according to whether or not to use insulin,and 49 normal pregnant women were set as the control group.The levels of total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein a,apolipoprotein A1(ApoA1)and apolipoprotein B(ApoB)were compared among three groups.The correlation between blood lipid level and type A2 GDM was analyzed.Results:The differences of the levels of TG,HDL-C,ApoA1,lipoprotein a between the midtrimester A2 experimental group and control group,and the levels of TC,TG,HDL-C and ApoA1 between the last trimester A2 experimental group and control group were statistically significant(P<0.05 to P<0.01).The differences of the levels of HDL-C,ApoA1 and lipoprotein a in midtrimester between the A1 and A2 experimental groups,and the levels of ApoA1 and HDL-C in last trimester between the A1 and A2 experimental groups were statistically significant(P<0.01).The results of logistic regression analysis showed that the level of ApoA1 in midtrimester and level of HDL-C in last trimester were closely related to type A2 GDM.When the ROC curve analysis was used to predict the occurrence of A2 type GDM during pregnancy,the area under the curve was 0.869,the 95%CI was 0.795-0.943,and the prediction reliability of which was higher(P<0.05).Conclusions:The level of ApoA1 in midtrimester and levels of TC and HDL-C in last trimester are closely related to the occurrence and development of type A2 GDM.