孕中期孕妇体力活动、增重速率及APN水平与妊娠糖尿病的关系

Study on synergistic effects of physical activity,weight gain rate,and APN levels of pregnant women in second trimester on risk of GDM

目的探讨孕中期孕妇体力活动、增重速率及脂联素(APN)水平在妊娠糖尿病(GDM)发生、发展中的作用。方法选取2019年1月—2022年7月在南通市妇幼保健院治疗的GDM孕妇120例(GDM组),同时选取健康孕妇360例为对照组。比较两组孕妇的血红蛋白(Hb)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、总胆红素(TBIL)、直接胆红素(DBIL)水平,以及体力活动、增重速率;采用酶联免疫吸附试验检测血清APN水平;影响因素的分析采用多因素Logistic回归模型。结果GDM组的年龄、孕前体质量指数、糖尿病家族史占比和孕期喜食甜食占比高于对照组(P<0.05),GDM组体力活动程度占比低于对照组(P<0.05),GDM组的增重速率高于对照组(P<0.05),GDM组的TG高于对照组(P<0.05),而TBIL、DBIL和APN低于对照组(P<0.05)。多因素Logistic回归分析结果显示,年龄[OR=2.440(95%CI:1.401,4.249)]、孕前体质量指数[OR=2.748(95%CI:1.704,4.434)]、糖尿病家族史[OR=1.759(95%CI:1.232,2.514)]、体力活动[OR=0.513(95%CI:0.343,0.767)]、增重速率[OR=2.059(95%CI:1.222,3.467)]和APN[OR=0.509(95%CI:0.332,0.778)]是GDM发生的影响因素(P<0.05)。结论体力活动、增重速率、APN是GDM的独立影响因素,在孕期过程中应加以重视。

Objective To explore the role of physical activity,weight gain rate,and adiponectin(APN)in the development of gestational diabetes mellitus(GDM)in the second trimester.Methods From January 2019 to July 2022,120 cases of GDM parturients treated in our hospital(GDM group)were selected,and 360 cases of normal parturients were selected as the control group(control group).The differences in clinical data,physical activity,weight gain rate,APN,and other indicators between the two groups were compared.Results Age,body mass index(BMI)before pregnancy,family history of diabetes,and the dessert prone ratio in pregnancy in the GDM group were higher than the control group,the difference was statistically significant(P<0.05).The comparison of physical activity degree between GDM group and control group was statistically significant(P<0.05),and GDM group was lower than control group.Difference of weight gain rate between GDM group and control group was statistically significant(P<0.05),and GDM group was higher than control group.The comparison of triglyceride(TG),total bilirubin(TBIL),direct bilirubin(DBIL),and APN between GDM group and control group showed statistically significant differences(P<0.05).TG in GDM group was higher than that in control group,while TBIL,DBIL,and APN were lower than that in control group(P<0.05).Multivariate Logistic regression analysis showed that:age[OR=2.440(95%CI:1.401,4.249)],BMI before pregnancy[OR=2.748(95%CI:1.704,4.434)],family history of diabetes[OR=1.759(95%CI:1.232,2.514)],physical activity degree[OR=0.513(95%CI:0.343,0.767)],weight gain rate[OR=2.059(95%CI:1.222,3.467)],and APN[OR=0.509(95%CI:0.332,0.778)]were influence factors of GDM(P<0.05).Conclusion Physical activity,weight gain rate,APN are independent influencing factors of GDM,which should be paid attention to during pregnancy.