宁德地区妊娠期糖尿病发病风险和血糖控制的关系

Relationship between risk of the diabetes in pregnancy and blood glucose control in Ningde area

目的探究宁德地区妊娠期糖尿病发病现状及体质指数(Body Mass Index,BMI)与其发病风险和血糖控制的关系。方法选择2021年6月至2023年6月宁德师范学院附属宁德市医院的孕妇资料,将符合标准的323例纳入研究,列为观察组妊娠期糖尿病(gestational diabetes mellitus,GDM)。纳入同期300例无GDM且顺利分娩孕妇资料作为对照组(非GDM孕妇)。比较患病现状、分析BMI与发病风险、血糖控制的关系。结果与非GDM孕妇比较,GDM孕妇年龄、孕前BMI、妊娠期增重≥15 kg人数、ALT水平、不良孕产史人数和不规律产检分布差异具有统计学意义(均P<0.05)。非GDM患者孕前正常BMI(60.00%)和超重(23.33%)占比较高,GDM孕妇孕前超重(60.99%)和肥胖(19.20%)占比高,两组孕妇BMI分布差异明显(P<0.001)。孕前BMI与GDM发病呈极显著关系(P<0.001)。用孕妇身高、孕前体重、年龄对BMI于GDM的关系进行调整,结果显示,调整后BMI与GDM的关系具有统计学意义(均P<0.05)。三组不同OGTT检测结果GDM孕妇BMI差异有统计学意义(F=29.426,P<0.001),Ⅲ组孕妇妊娠期增重≥15 kg的人数最多,Ⅱ组其次,Ⅰ组人数最少,差异有统计学意义(χ^(2)=74.346,P<0.001)。结论宁德地区GDM孕妇具有年龄偏大,孕前BMI、ALT水平高,妊娠期增重≥15 kg、不规律产检和不良孕产史的特征;孕前BMI与GDM发病和妊娠期血糖控制具有明显相关性。

Objective To investigate the current situation of gestational diabetes mellitus(GDM)and the relationship between body mass index(BMI)and risk of diabetes mellitus in pregnancy and glycemic control in Ningde area.Methods The data of pregnant women in Ningde Municipal Hospital affiliated to Ningde Normal University from June 2021 to June 2023 were selected,and 323 cases meeting the criteria were included in the study as the observation group(GDM pregnant women).During the same period,300 cases of pregnant women without GDM and successfully delivered were included as the control group(non-GDM pregnant women).The disease-related information between the two groups was compared,and the relationship between BMI and the risk of morbidity and glycemic control was analyzed.Results Compared with non-GDM pregnant women,the differences in the distribution of age,pre-pregnancy BMI,number of people who gained≥15 kg during pregnancy,ALT level,adverse pregnancy history and irregularity of obstetrics tests were statistically significant(all P<0.05)in GDM pregnant women.Non-GDM patients had a higher percentage of normal pre-pregnancy BMI(60.00%)and overweight(23.33%),while GDM pregnant women had a higher percentage of pre-pregnancy overweight(60.99%)and obesity(19.20%),and the difference in the distribution of pre-pregnancy BMI between the two groups was significant(P<0.001).Pre-pregnancy BMI was significantly associated with the development of GDM(P<0.001).The relationship between BMI and GDM was adjusted using pregnant women′s height,pre-pregnancy weight and age,and the results showed that the adjusted relationship between BMI and GDM was statistically significant(all P<0.05).The difference in BMI among pregnant women with GDM in the three groups with different OGTT test results was statistically significant(F=29.426,P<0.001),and the number of pregnant women with gestational weight gain of≥15 kg was the highest in groupⅢ,followed by groupⅡ,and the lowest number in group I,with a statistically significant difference(χ^(2)=74.346,P<0.001).Conclusion Pregnant women with GDM in Ningde area are characterized by older age,high pre-pregnancy BMI and ALT levels,gestational weight gain of≥15 kg,irregular obstetric checkups,and a history of adverse pregnancy and childbirth.Prepregnancy BMI has a significant correlation with the onset of GDM and glycemic control during pregnancy.