铁代谢与孕中晚期妊娠期糖尿病发生的关系

Correlation between iron metabolism and gestational diabetes mellitus in mid to late pregnancy

目的探讨孕早期影响孕中晚期妊娠期糖尿病(GDM)发生的相关因素及其对GDM的早期预测价值。方法根据孕24~28周口服葡萄糖耐量试验(OGTT)检测结果,99例单胎孕妇分为GDM组(诊断GDM,45例)和对照组(OGTT正常,54例),比较两组患者一般资料及孕早期(孕12周)Hb和血清铁蛋白(SF)、孕晚期(孕36周)Hb和FBG。采用多因素logistic回归分析GDM发生的影响因素。绘制ROC曲线分析孕早期BMI、Hb和SF单独及联合检测对GDM的早期预测价值。结果GDM组患者孕早期体重、BMI及新生儿体重高于对照组(P<0.05)。GDM组孕早期Hb和SF、孕晚期Hb和FBG均高于对照组(P<0.05)。多因素logistic回归分析结果显示,孕早期BMI、Hb和SF升高是孕妇孕中晚期发生GDM的独立危险因素(P<0.05)。孕早期BMI、Hb、SF单独和联合检测预测GDM发生的AUC分别为0.708[95%CI(0.600~0.816),P<0.05]、0.678[95%CI(0.572~0.784),P<0.05]、0.658[95%CI(0.550~0.766),P<0.05]和0.785[95%CI(0.692~0.877),P<0.05]。结论孕早期BMI、Hb和SF升高与GDM的发生存在一定的关系,三者联合检测可以提高对GDM的预测价值。

Objective To explore the relevant factors influencing the occurrence of gestational diabetes mellitus(GDM)in mid to late pregnancy and their early predictive value for GDM.MethodsAccording to the results of oral glucose tolerance test at 24-28 weeks of pregnancy,99 singleton pregnant women were divided into two groups of GDM(with GDM,45 cases)and C(with normal glucose tolerance,54 cases).The general information,Hb and serum ferritin(SF)in early pregnancy(12 weeks of pregnancy),Hb and FBG in late pregnancy(36 weeks of pregnancy)were compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors for GDM occurrence.ROC curve was used to analyze the early predictive values of BMI,Hb and SF alone and in combination detected in early pregnancy for GDM.Results The weight,BMI in early pregnancy and newborn weight in group GDM were higher than those in group C(P<0.05).The levels of Hb and SF in early pregnancy,Hb and FBG in late pregnancy in group GDM were higher than those in group C(P<0.05).The results of multivariate logistic regression analysis showed that elevated BMI,Hb and SF in early pregnancy were the independent risk factors for GDM in mid to late pregnancy(P<0.05).The AUC values of BMI,Hb,and SF alone and in combination detected in early pregnancy to predict GDM occurrence were 0.708[95%CI(0.600-0.816),P<0.05],0.678[95%CI(0.572-0.784),P<0.05],0.658[95%CI(0.550-0.766),P<0.05],and 0.785[95%CI(0.692-0.877),P<0.05],respectively.Conclusion There is a certain correlation between the increase of BMI,Hb,and SF in early pregnancy and the occurrence of GDM,and the combined detection of the three indicators can improve the predictive value of GDM.