早孕期血红蛋白水平与发生妊娠期糖尿病的相关性分析

Correlation Analysis of Hemoglobin Level in Early Pregnancy and Occurrence of Gestational Diabetes

目的探讨早孕期血红蛋白(Hb)水平与发生妊娠期糖尿病(GDM)的相关性。方法选取单胎孕妇共481例。记录孕妇的年龄、身高、体质量、孕次等一般资料,于妊娠早期测定体质量指数(BMI)、血压、Hb水平、丙氨酸转氨酶(ALT)、肌酐(Cr)、空腹血糖(FPG)、新生儿体质量、分娩孕周等。于24~28周行口服糖耐量试验(OGTT),结果异常者为GDM组(200例),正常者为对照组(281例);按照妊娠早期Hb水平,分为高Hb水平(Hb≥130 g/L)组101例和非高Hb水平(Hb<130 g/L)组380例。比较两组孕妇的一般资料、不同Hb水平组中GDM发病率及高Hb水平与发生GDM的相关性。结果GDM组的收缩压、舒张压、早孕期FPG、新生儿体质量、早孕期Hb水平均高于对照组(P<0.05);高Hb水平组的收缩压、舒张压、FPG高于非高Hb水平组(P<0.05)。高Hb组的GDM发生率明显高于对照组(χ2=161.83,P<0.05);经Logistics回归分析,高Hb水平是发生GDM的独立风险因子。结论早孕期高Hb水平与GDM的发生明显相关。

Objective To explore the correlation between the level of hemoglobin in early pregnancy and the occurrence of gestational diabetes(GDM).Methods A total of 481 pregnant women with singletons from January 2018 to December 2019 were recruited.Record all data of pregnant women,and measure body mass index,blood pressure,blood Hb level,alanine aminotransferase,creatinine,and fasting plasma glucose in the first trimester,neonatal weight,gestational week of delivery,etc.The oral glucose tolerance test(OGTT)was performed from 24 to 28 weeks.The abnormal results were 200 cases in the GDM group(experimental group),and 281 cases in the normal group were the non-GDM group(control group);according to the Hb level in early pregnancy,it was divided into high Hb levels roup(101 cases;Hb≥130 g/L)and the non-high Hb level(380 cases;Hb<130 g/L),comparing the general data of pregnant women in the two groups,the incidence of GDM and the high Hb level and incidence in different Hb level groups associated with GDM.Results The Hb level of pregnant women in the GDM group in early pregnancy was significantly higher than that in the control group(P<0.05).The systolic blood pressure,the diastolic blood pressure and the neonatal weights of GDM pregnant women were all higher than that of the control group respectively(P<0.05).Fasting plasma glucose in early pregnancy was also significantly higher than that in the control group(P<0.05).High Hb group(Hb≥130 g/L)compared with the control group(Hb<130 g/L)had the incidence of GDM significantly higher than that of the control group(χ2=161.83,P<0.05).After regression analysis,high Hb level was an independent risk factor for GDM.Conclusion The high hemoglobin level in early pregnancy is obviously related to the occurrence of gestational diabetes.