1256例妊娠期糖尿病相关危险因素分析

Study on Risk Factors of 1256 Cases of Gestational Diabetes Mellitus

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)的相关危险因素,为GDM的预防提供理论依据。方法选取南京医科大学附属淮安第一医院2016年12月-2017年12月产科进行常规产检的孕妇为研究对象,调查研究对象基本情况、饮食情况及收集血清学指标,对GDM的可能危险因素进行单因素及多因素Logistic回归分析。结果(1)共1256例孕妇参与研究,GDM的病例数为173例(GDM组),占13.77%,(非GDM者1083例(non-GDM组)占86.23%。(2)单因素分析显示:一般特征方面GDM组与non-GDM组在年龄、文化程度、家庭收入、孕期增重、孕前BMI、孕次、产次、父母糖尿病史、日运动量方面的差异均有统计学意义(P均<0.05);饮食因素方面GDM组与non-GDM组在是否喜食甜食、每日水果摄入量、每日主食摄入量、精制谷物列比例、高脂食品摄入频率、每日食盐摄入量、每日油摄入量、是否喝含糖饮料、外地就餐频率、每日肉摄入量等方面差异均有统计学意义(P均<0.05);血清学指标方面GDM组与non-GDM组孕妇血清中Hb、TG、TB、LDL、HDL、TBil、DBil、IBil、MDA、SOD水平差异均有统计学意义(P均<0.05)。(3)多因素Logistic回归分析显示:孕妇年龄偏大、孕前BMI偏高、父母亲有糖尿病史、精制谷物比例高、高脂食品摄入频率高、TG和MDA水平高是GDM发病的独立危险因素(OR>1),体力活动较多以及较低的TBil和HDL水平是GDM发病的保护性因素(OR<1)。结论GDM的发病是多种因素共同作用的结果,临床应针对GDM发生的各种因素采取相应干预措施。

Objective To investigate the risk factors of gestational diabetes mellitus(GDM)and provide theoretical basis for the prevention of GDM.Methods The pregnant women from the Huai’an First Affiliated of Nanjing Medical University from December 2016 to December 2017 were enrolled in the study.The basic conditions,dietary status and serological indicators were collected to investigate the possible risk factors of GDM by univariate analysis and multivariate logistic regression analysis.Results A total of 1256 subjects were investigated in this study,including 173 pregnant women with GDM,and the prevalence of GDM was 13.77%.Single factor analysis showed that there were statistically significant differences between GDM group and nonGDM group in terms of age,education level,family income,weight gain during pregnancy,BMI before pregnancy,pregnancy time,birth time,history of parent-child diabetes,daily exercise volume(P<0.05).About dietary factors,there were statistical differences between GDM group and non-GDM group in the aspects of whether they liked sweet food,daily fruit intake,daily staple food intake,proportion of refined grains,intake frequency of high-fat food,daily salt intake,daily oil intake,whether they drank sugary drinks,eating frequency in other places and daily meat intake.The levels of Hb,cholesterol,bilirubin,MDA and SOD in serum were different(P<0.05).Multivariate logistic regression analysis showed that age of pregnant women(larger),pre-pregnancy BMI(higher),history of diabetes in parents,proportion of refined grains(high),frequency of high-fat food intake,TG and MDA levels(high)was an independent risk factor for GDM(OR>1),and physical activity(more)and lower TBil and HDL levels were protective factors for GDM(OR<1).Conclusion The incidence of GDM is the result of a combination of factors.The clinical measures should be taken to strengthen the intervention and prevention of GDM.