妊娠期糖尿病孕妇糖基化间隙水平和母婴结局的关系

Relationship between the level of glycation gap and maternal and fetal outcomes in pregnant women with gestational diabetes mellitus

目的分析妊娠期糖尿病(GDM)患者中不同糖基化间隙(GG)水平与母婴妊娠结局的相关性,探讨GG在GDM病情监测中的意义。方法选取2017年1月—2020年6月在新疆阿克苏地区第一人民医院行产前检查并分娩的213例GDM孕产妇为研究对象,根据产前糖化血红蛋白(HbA1c)和果糖胺计算GG,采用三分位法将产妇分为低GG组(71例)、中GG组(71例)和高GG组(71例),比较3组的母婴结局,分析不同GG水平与母婴结局的相关性。结果3组孕妇发生羊水过多(12.7%vs.21.1%vs.29.6%)、胎膜早破(7.0%vs.12.7%vs.25.4%)、剖宫产(16.9%vs.38.0%vs.46.5%)的比例比较,差异有统计学意义(P<0.05)。3组围生儿中早产儿比例(7.0%vs.16.9%vs.26.8%)、巨大儿比例(16.9%vs.22.5%vs.35.2%)、新生儿低血糖比例(14.1%vs.23.9%vs.36.6%)比较,差异有统计学意义(P<0.05)。结论GDM产妇GG水平与母婴结局密切相关,GG水平越高,妊娠与分娩期间发生母婴并发症的概率就越大;可将GG作为孕妇血糖控制的重要监测指标。

Objective To analyze the relationship between levels of glycation gap(GG)and the maternal and fetal outcomes in pregnant women with GDM,and to explore the significance of GG in the monitoring of the disease.Methods 213 GDM women under-went antenatal examination and delivery in our hospital were selected as study objects,all cases were given health guidance and actively blood sugar control.All the subjects were divided into three groups according to tertiles of GG values:low GG group,middle GG group and high GG group,compare three groups of maternal and neonatal outcomes and analysis the relationship between GG levels and maternal and infant outcomes.Results The three groups of pregnant women have polyhydramnios(12.7%vs.21.1%vs.29.6%),premature rupture of membranes(7.0%vs.12.7%vs.25.4%),and cesarean section(16.9%vs.38.0%vs.46.5%).There is statistical significance(P<0.05).Among the three groups of perinatal infants,the proportion of premature infants(7.0%vs.16.9%vs.26.8%),the proportion of macrosomia(16.9%vs.22.5%vs.35.2%),and the proportion of neonatal hypoglycemia(14.1%vs.23.9%vs.36.6%)The difference was statistically significant(P<0.05).Conclusion GDM women whose GG level is closely related to maternal and infant outcomes,the higher level of GG,the higher risk of maternal and infant complications.GG can be viewed as and important monitoring indicator for blood sugar control of GDM women.