妊娠期糖尿病流行病学特征及危险因素和预防措施分析

Epidemiological characteristics and risk factors of gestational diabetes mellitus

目的探讨妊娠期糖尿病流行病学特征及危险因素和预防措施。方法选取衢州市中医医院2017年6月至2018年6月期间收治的妊娠期糖尿病患者183例作为研究组,另选择同期正常妊娠孕妇150例作为对照组。调查资料包括年龄、孕次、产次、孕前体质量指数(BMI)、糖尿病家族史、瘦素、脂联素、孕前或孕期超重、喜吃甜食、妊娠期高血压。采用酶联免疫吸附法测定瘦素和脂联素含量。采用多因素logistic回归分析影响妊娠期糖尿病危险因素。结果研究组空腹血糖(7.24±1.08)mmol/L和餐后2 h血糖(13.19±2.06)mmol/L高于对照组(5.36±0.62)mmol/L和(6.41±1.21)mmol/L,(t=18.914、35.585,P<0.05)差异有统计学意义。两组平均年龄、平均孕次和平均产次比较差异无统计学意义(P>0.05)。研究组孕前BMI≥25 kg/m^2、糖尿病家族史、瘦素水平、脂联素水平、孕前或孕期超重、喜吃甜食均高于对照组,差异有统计学意义(P<0.05)。将上述单因素分析差异有统计学意义的纳入多因素logistic回归分析显示,孕前BMI≥25 kg/m^2、糖尿病家族史、孕前或孕期超重、瘦素、脂联素和喜吃甜食为影响妊娠期糖尿病独立危险因素。结论妊娠期糖尿病发病多因素影响,其中孕前BMI、糖尿病家族史、孕前或孕期超重、瘦素、脂联素和喜吃甜食为其独立危险因素,为降低妊娠期糖尿病发病,应针对相关影响因素采取相关预防措施。

Objective To discuss the epidemiological characteristics,risk factors and preventive measures of gestational diabetes mellitus.Methods 183 women with gestational diabetes mellitus admitted to Quzhou Hospital of Traditional Chinese Medicine from June 2017 to June 2018 were selected as the study subjects,meanwhile 150 healthy pregnant women in the same period were selected as study controls.Survey data included age,number of pregnancies,parity,BMI,family history of diabetes,serum levels of leptin and adiponectin,overweight before or during pregnancy,sugar consumption and gestational hypertension.Serum levels of leptin and adiponectin were measured by ELISA.Multivariate logistic regression analysis was used to analyze the risk factors of gestational diabetes mellitus.Results Both the fasting and postprandial blood glucose of subjects in study group were significantly higher than those in the control group(7.24±1.08 vs 5.36+0.62;13.19+2.06 vs 6.41+1.21 mmol/L;t=18.914,35.585,P<0.05).There were no significant differences in mean age,average number of pregnancy and childbirth rate between the two groups(P>0.05).There were more women with pre-pregnancy BMI≥25 kg/m^2,family history of diabetes mellitus,higher levels of leptin and adiponectin,overweight before or during pregnancy and sweet teeth in the study group(P<0.05).The logistic regression analysis showed that BMI≥25 kg/m2 before pregnancy,family history of diabetes mellitus,overweight before or during pregnancy,serum levels of leptin and adiponectin and sweet teeth were independent risk factors for gestational diabetes mellitus.Conclusions Pre-pregnancy BMI,family history of diabetes mellitus,pre-pregnancy or pregnancy overweight,leptin and adiponectin levels and sweet teeth are independent risk factors of gestational diabetes mellitus.In order to reduce the incidence of gestational diabetes mellitus,relevant preventive measures should be taken accordingly with the relevant factors.