Intricacies during pregnancy with gestational diabetes mellitus

The study by Cao et al aimed to identify early second-trimester biomarkers that could predict gestational diabetes mellitus(GDM)development using advanced proteomic techniques,such as Isobaric tags for relative and absolute quantitation isobaric tags for relative and absolute quantitation and liquid chromatography-mass spectrometry liquid chromatography-mass spectrometry.Their analysis revealed 47 differentially expressed proteins in the GDM group,with retinol-binding protein 4 and angiopoietin-like 8 showing significantly elevated serum levels compared to controls.Although these findings are promising,the study is limited by its small sample size(n=4 per group)and lacks essential details on the reproducibility and reliability of the protein quantification methods used.Furthermore,the absence of experimental validation weakens the interpretation of the protein-protein interaction network identified through bioinformatics analysis.The study's focus on second-trimester biomarkers raises concerns about whether this is a sufficiently early period to implement preventive interventions for GDM.Predicting GDM risk during the first trimester or pre-conceptional period may offer more clinical relevance.Despite its limitations,the study presents valuable insights into potential GDM biomarkers,but larger,well-validated studies are needed to establish their predictive utility and generalizability.

Prediction of Gestational Diabetes Mellitus in Early Pregnancy: Is Abdominal Skin Fold Thickness 20 mm or More an Independent Risk Predictor?

Background: Gestational Diabetes Mellitus (GDM) is associated with several maternal and perinatal complications. Early detection and treatment can improve pregnancy outcomes. Objectives: To determine the prevalence, risk factors and predictors of GDM in early pregnancy at the University of Port Harcourt Teaching Hospital, (UPTH), Port Harcourt Nigeria. Methods: A cohort of 235 mothers who registered for antenatal care between 15 - 18 weeks of gestation at UPTH was prospectively studied. Their socio-demographic data, examination findings, anthropometric measurements, fasting blood sugar at booking and OGTT results at 28 weeks gestation were collated and entered into PC with SPSS for windows version 21.0 which was also used for the analysis. Variables were expressed as absolute numbers, percentages or means with standard deviations and significant differences determined using chi square test or the student “t” test as appropriate. The level of significance was set at P < 0.05. Results: Of the 235 participants, 35 (14.9%) developed GDM. Women who had GDM were significantly older (P = 0.001), had higher weight (t = 2.95, P = 0.01), BMI (t = 2.29, P = 0.02), abdominal skin fold thickness (t = 4.15, P = 0.001), blood pressure (t = 3.38, P = 0.001) compared to women who did not. Previous history of GDM was significantly different between two groups as χ2 = 93.56 and P = 0.001. Abdominal skin fold thickness and prior GDM history were found to be independent predictors of GDM on application of multiple logistic regression analysis. Conclusion: The prevalence of GDM in Port Harcourt is 14.9% and major risk factors are obesity, previous GDM history, advanced age and hypertension. Abdominal skin fold thickness ≥ 20 mm is an independent predictor. The risk of developing GDM can be predicted in early second trimester using algorithm incorporating risk factor screening and anterior abdominal wall skin fold thickness estimation.

Application of machine learning algorithm for predicting gestational diabetes mellitus in early pregnancy

Objective:To study the application of a machine learning algorithm for predicting gestational diabetes mellitus(GDM)in early pregnancy.Methods:This study identified indicators related to GDM through a literature review and expert discussion.Pregnant women who had attended medical institutions for an antenatal examination from November 2017 to August 2018 were selected for analysis,and the collected indicators were retrospectively analyzed.Based on Python,the indicators were classified and modeled using a random forest regression algorithm,and the performance of the prediction model was analyzed.Results:We obtained 4806 analyzable data from 1625 pregnant women.Among these,3265 samples with all 67 indicators were used to establish data set F1;4806 samples with 38 identical indicators were used to establish data set F2.Each of F1 and F2 was used for training the random forest algorithm.The overall predictive accuracy of the F1 model was 93.10%,area under the receiver operating characteristic curve(AUC)was 0.66,and the predictive accuracy of GDM-positive cases was 37.10%.The corresponding values for the F2 model were 88.70%,0.87,and 79.44%.The results thus showed that the F2 prediction model performed better than the F1 model.To explore the impact of sacrificial indicators on GDM prediction,the F3 data set was established using 3265 samples(F1)with 38 indicators(F2).After training,the overall predictive accuracy of the F3 model was 91.60%,AUC was 0.58,and the predictive accuracy of positive cases was 15.85%.Conclusions:In this study,a model for predicting GDM with several input variables(e.g.,physical examination,past history,personal history,family history,and laboratory indicators)was established using a random forest regression algorithm.The trained prediction model exhibited a good performance and is valuable as a reference for predicting GDM in women at an early stage of pregnancy.In addition,there are cer tain requirements for the propor tions of negative and positive cases in sample data sets when the random forest algorithm is applied to the early prediction of GDM.

Early neonatal complications in pregnant women with gestational diabetes mellitus and the effects of glycemic control on neonatal infection

BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal infection.METHODS The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were compared.The patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to standards.Baseline data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two groups.RESULTS The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P<0.05).Pregnant women with GDM in the NCGC group(n=178)had significantly higher fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group(n=58)(P<0.05).There were no differences in baseline data between the two groups(P>0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(P<0.05),while white blood cells,serum procalcitonin and C-reactive protein levels increased significantly.The neonatal infection rate was also significantly increased in the NCGC group(P<0.05).CONCLUSION The risk of neonatal complications increased in pregnant women with GDM.Poor glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.

Study on the correlation and predictive value of serum pregnancyassociated plasma protein A, triglyceride and serum 25-hydroxyvitamin D levels with gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.

Food Intake Characteristics during Early Pregnancy in Women with Gestational Diabetes Mellitus

To investigate the characteristic food intake during early pregnancy in women with gestational diabetes mellitus (GDM) in a rural city in Aomori Prefecture, Japan, one hundred and twenty-one women were recruited and queried about their habitual dietary intake. Food intake of patients was assessed using the model nutritional balance chart at 12 - 16, 24 - 28, and 34 - 36 weeks of gestation. Of the 121 pregnant women examined, 19 were obese. During early pregnancy, food intake ratios of the obese women were significantly lower than those of the non-obese women for the categories of milk (p < 0.001) and sugar (p < 0.05). GDM group was 7 women among 19 women in obesity group during mid-pregnancy. During early pregnancy, women with GDM had significantly higher sugar intake ratios than women without GDM (p < 0.05). These results suggested that obese pregnant women are able to prevent GDM by limiting their sugar intake during early pregnancy.

Excessive gestational weight gain in early pregnancy and insufficient gestational weight gain in middle pregnancy increased risk of gestational diabetes mellitus

Background:Gestational weight gain(GWG)is associated with the risk of gestational diabetes mellitus(GDM).However,the effect of weight gain in different trimesters on the risk of GDM is unclear.This study aimed to evaluate the effect of GWG on GDM during different trimesters.Methods:A birth cohort study was conducted from 2017 to 2020 in Shenzhen,China.In total,51,205 participants were included comprising two models(early pregnancy model and middle pregnancy model).Gestational weight(kg)was measured at each prenatal clinical visit using a standardized weight scale.Logistic regression analysis was used to assess the risk of GDM.Interaction analysis and mediation effect analysis were performed in the middle pregnancy model.Results:In the early pregnancy model,the risk of GDM was 0.858 times lower(95%confidence interval[CI]:0.786,0.937)with insufficient GWG(iGWG)and 1.201 times higher(95%CI:1.097,1.316)with excessive GWG after adjustment.In the middle pregnancy model,the risk of GDM associated with iGWG increased 1.595 times(95%CI:1.418,1.794)after adjustment;for excessive GWG,no significant difference was found(P=0.223).Interaction analysis showed no interaction between GWG in early pregnancy(GWG-E)and GWG in middle pregnancy(GWG-M)(F=1.268;P=0.280).The mediation effect analysis indicated that GWG-M plays a partial mediating role,with an effect proportion of 14.9%.Conclusions:eGWG-E and iGWG-M are associated with an increased risk of GDM.Strict control of weight gain in early pregnancy is needed,and sufficient nutrition should be provided in middle pregnancy.

Diagnostic Value of Sensitive Biomarkers for Early Kidney Damage in Diabetic Patients with Normoalbuminuria

To the Editor:Diabetic kidney disease (DKD)is the most common cause of end-stage renal disease (ESRD);however,the onset of DKD is difficult to detect.[1]When persistent microalbuminuria becomes detectable,DKD has already progressed to the third disease stage,and finding biomarkers that are more sensitive than microalbuminuria is therefore necessary to indicate kidney damage at an earlier stage of DKD.[2]Both glomerular and tubulointerstitial damages have been repeatedly demonstrated to be important factors in the pathophysiology of DKD.[3] Therefore,we investigated the expression levels of six markers closely related to the glomerulus and renal tubule.

孕早期孕妇促甲状腺激素、甲状腺过氧化物酶抗体及微小RNA-873-5p水平与妊娠期糖尿病相关性研究

目的:分析研究孕早期促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)及微小RNA-873-5p(miR-873-5p)水平与妊娠期糖尿病(GDM)的相关性。方法:选取定期产检的GDM孕妇命名为GDM组(n=109),另选同期在本院产检的糖耐量正常孕妇为对照组(n=60)。收集两组孕妇的一般资料及孕早期实验室检测指标(TSH、TPOAb、miR-873-5p),采用单因素、多因素分析TSH、TPOAb、miR-873-5p水平与GDM的关系;并绘制ROC曲线分析血清TSH、TPOAb、miR-873-5p水平对GDM的预测价值。结果:GDM组的血清TSH、TPOAb、miR-873-5p水平均高于对照组,差异具有统计学意义(均P<0.05);多因素Logistic回归分析显示,年龄>30岁(OR=1.982)、孕前BMI≥24 kg/m^(2)(OR=2.020)、TSH升高(OR=2.113)、TPOAb升高(OR=2.307)及miR-873-5p水平升高(OR=2.059)是发生GDM的独立危险因素(均P<0.05);ROC曲线分析显示,血清TSH、TPOAb、miR-873-5p及联合检测的曲线下面积(AUC)分别为0.830、0.829、0.762、0.936,联合检测优于单一检测(P<0.05)。结论:TSH、TPOAb及miR-873-5p在GDM孕妇体内呈高表达,可能成为GDM发生的辅助预测指标。

妊娠早期血炎症指标、空腹血糖及血脂对妊娠期糖尿病的联合预测价值

目的探讨妊娠早期(孕6~13^(+6)周)孕妇血炎症指标、空腹血糖及血脂与妊娠期糖尿病(GDM)的关系。方法选择2020年11月至2021年10月在新乡医学院第一附属医院进行产检的98例妊娠早期孕妇为研究对象,依据受试者妊娠中期(孕24~28周)的口服葡萄糖耐量试验结果将其分为GDM组(n=35)和糖耐量正常(NGT)组(n=63)。所有受试者于孕6~13^(+6)周时空腹8 h以上,于第2天清晨抽取肘正中静脉血,测定白细胞(WBC)计数、中性粒细胞计数(NC)、淋巴细胞计数(LC)、单核细胞计数(MC)、空腹血糖(FPG)及血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,比较GDM组与NGT组孕妇各指标之间的差异。应用多因素logistic回归模型寻求联合预测因子并进行GDM发生的独立危险因素分析,采用受试者操作特征(ROC)曲线评估各危险因素预测GDM发生的效能。结果GDM组孕妇妊娠早期FPG、WBC计数、LC、TC、TG、LDL-C水平显著高于NGT组(P<0.05);GDM组与NGT组孕妇的NC、MC及HDL-C水平比较差异无统计学意义(P>0.05)。Logistic回归模型分析显示,FPG、WBC计数、TC、TG升高是GDM发生的独立危险因素(P<0.05)。以FPG=4.80 mmol·L^(-1)、WBC=9.35×10^(9)L^(-1)、TC=4.05 mmol·L^(-1)、TG=1.61 mmol·L^(-1)为截断值,预测GDM的ROC曲线下面积(AUC)分别为0.779、0.721、0.685、0.762,敏感度分别为0.886、0.514、0.857、0.543,特异度分别为0.587、0.857、0.524、0.873,四者联合预测GDM的AUC为0.876,灵敏度为0.857,特异度为0.810。妊娠早期FPG、WBC计数、TC、TG联合预测GDM的AUC高于FPG、WBC、TC、TG单独预测GDM的AUC。结论妊娠早期(孕6~13^(+6)周)孕妇血FPG、WBC计数、TC、TG是GDM的独立危险因素,可作为早期预测GDM发生的临床指标,且4项指标联合对GDM有更好的预测价值。

老年2型糖尿病合并高尿酸血症患者早期肾损害预测模型的构建与分析

目的 探讨老年2型糖尿病(T2DM)合并高尿酸血症患者早期肾损害发生情况及影响因素,并构建预测模型。方法 纳入老年T2DM合并高尿酸血症患者200例,根据是否发生早期肾损害将其分为早期肾损害组(96例)和非早期肾损害组(104例),收集其一般临床资料及实验室检查结果并进行组间比较。采用多因素logistic回归分析评估老年T2DM合并高尿酸血症患者发生早期肾损害的危险因素,并构建预测模型;采用受试者工作特征(ROC)曲线评价该模型的预测价值。结果 早期肾损害组患者年龄、糖尿病病程、糖化血红蛋白(HbA1c)、甘油三酯(TG)、血尿酸(SUA)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)及24 h尿微量白蛋白水平均高于非早期肾损害组(P<0.05)。多因素logistic回归分析结果显示,年龄、糖尿病病程、BMI、HbA1c、TG、SUA、CRP、Hcy及24 h尿微量白蛋白均是老年T2DM合并高尿酸血症患者发生早期肾损害的独立危险因素(P<0.05)。构建logistic回归预测模型,验证结果显示模型建立具有统计学意义、构建有效、拟合效果较好。ROC曲线分析结果显示,该logistic回归预测模型对老年T2DM合并高尿酸血症患者早期肾损害有较好的预测价值[ROC曲线下面积(AUC)为0.920],当Log(P)=3.77时,预测敏感度为76.04%,特异度为90.38%。结论 老年T2DM合并高尿酸血症患者早期肾损害发生率高达48%,其影响因素涉及年龄、糖尿病病程、BMI、HbA1c、TG、SUA、CRP、Hcy及24 h尿微量白蛋白,临床需根据上述因素重视对重点人群的筛查,加强对该群体早期肾功能损害的防治工作。

妊娠早期孕妇25(OH)D水平及其与妊娠期糖尿病的相关性研究

目的探讨南充地区妊娠早期孕妇血清25-羟基维生素D[25(OH)D]水平及其与发生妊娠期糖尿病(GDM)的关联。方法回顾性选取2019年1月至2022年12月在川北医学院附属医院早孕建册正规产检且资料完整的3491例孕妇为研究对象,收集孕妇的年龄、孕前及建册时体质量指数(BMI)、既往妊娠及分娩等一般资料,以及孕妇妊娠11~13+6周的血清25(OH)D水平和妊娠24~28周的75g口服葡萄糖耐量试验(OGTT)检测值。以OGTT结果将孕妇分为正常组(2916例)与GDM组(575例)。再以OGTT结果进行分层分组:①以OGTT空腹血糖水平为依据,将孕妇分为OGTT空腹血糖正常组(3201例)与OGTT空腹血糖异常组(290例);②以OGTT 1小时血糖水平为依据,将孕妇分为OGTT 1小时血糖正常组(3254例)与OGTT 1小时血糖异常组(237例);③以OGTT 2小时血糖水平为依据,将孕妇分为OGTT 2小时血糖正常组(3296例)与OGTT 2小时血糖异常组(195例);④在575例GDM孕妇中,将患者分为单指标组(符合OGTT的三项检测值中一项诊断标准的孕妇,450例)与多指标组(符合OGTT的二项及以上诊断标准的孕妇,125例)。比较各组间血清25(OH)D水平等检测指标;采用Spearman相关性分析妊娠早期血清25(OH)D水平与妊娠中期OGTT 1小时及OGTT 2小时血糖的相关性,通过Logistic回归分析妊娠早期血清25(OH)D水平与GDM发生的关系。结果研究共纳入3491份孕妇资料,其中正常组2916例(83.5%),GDM组575例(16.5%),GDM的发生率为16.5%。血清25(OH)D的严重缺乏者有1569例(44.9%),轻度缺乏者有1192例(34.2%),正常者有730例(20.9%)。正常组孕妇的血清25(OH)D水平中位数为32.3(22.3,46.4)nmol/L,GDM组为30.5(19.8,43.0)nmol/L,经比较差异具有统计学意义(Z=-3.713,P<0.001)。对OGTT结果进行分层分析,OGTT空腹血糖正常组孕妇血清25(OH)D水平与OGTT空腹血糖异常组比较,差异无统计学意义(Z=0.746,P=0.387);OGTT 1小时血糖正常组孕妇血清25(OH)D水平与OGTT 1小时血糖异常组比较,差异有统计学意义(Z=21.509,P<0.001);OGTT 2小时血糖正常组孕妇血清25(OH)D水平与OGTT 2小时血糖异常组比较,差异有统计学意义(Z=44.924,P<0.001);在575例GDM孕妇中,符合OGTT的三项检测值中一项诊断标准(单指标组)的孕妇血清25(OH)D水平与符合二项及以上诊断标准(多指标组)者比较,差异有统计学意义(Z=58.717,P<0.001)。血清25(OH)D与OGTT空腹血糖无明显相关性(r=0.009,P>0.05),而与OGTT 1小时和OGTT 2小时血糖均呈明显负相关(r值分别为-0.070、-0.085,P<0.05)。妊娠早期严重缺乏25(OH)D的孕妇患GDM的风险是正常者的1.299倍(OR=1.299,95%CI:1.018~1.657,P=0.036)。结论南充地区孕妇妊娠早期血清25(OH)D水平普遍偏低,且严重缺乏25(OH)D的妊娠早期孕妇患GDM的风险显著增加。

早期营养干预联合健康宣教对妊娠糖尿病脂代谢及生活质量的影响研究

目的探讨早期营养干预联合健康宣教对妊娠糖尿病脂代谢及生活质量的影响。方法选取2020年8月至2021年10月于泉州市妇幼保健院治疗的妊娠糖尿病孕妇196例作为研究对象,采用随机数表法将其分为观察组和对照组,每组各98例。对照组患者采用常规护理方式,观察组患者采用早期营养干预联合健康宣教的方式进行干预。比较两组妊娠糖尿病患者血糖水平、生活质量、疾病认知度评分及血脂水平。结果干预2周后,观察组妊娠糖尿病孕妇空腹、餐后2h及睡前血糖水平均较对照组低,差异有统计学意义(P<0.05);干预2周后,观察组妊娠糖尿病孕妇生活质量量表(GDMQ)各项评分及中文修订版疾病认知问卷(CIPQ-R)均高于对照组,差异有统计学意义(P<0.05);观察组孕妇总胆固醇(TC)、三酰甘油(TG)水平较对照组低,差异有统计学意义(P<0.05)。结论采用早期营养干预联合健康宣教模式能有效提高妊娠糖尿病孕妇疾病认知度,改善其生活质量,并能调节孕妇的血糖及血脂水平。

综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇的效果

目的观察综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇的效果及对妊娠结局的影响效果。方法选取2021年7月至2022年6月收治于宿迁市第一人民医院的高龄妊娠期糖尿病患者90例为研究对象。采用随机数字表法将90例高龄妊娠期糖尿病患者分为试验组和对照组,每组45例。对照组遵循妊娠期糖尿病常规宣教法施护,试验组在此基础之上引入综合性早期饮食宣教指导干预机制,对2组干预后的各观察指标进行比较。结果试验组高龄妊娠期糖尿病患者饮食控制认知度评分、饮食控制依从性评分与对照组比较,差异均有统计学意义(P<0.05),试验组血糖控制成效测评指标优于对照组,不良妊娠结局率低于对照组(P<0.05)。结论采用综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇施加干预,利于其饮食控制认知度、依从度的提升,可取得较佳血糖控制成效、减低不良妊娠结局概率。

早期护理干预在妊娠期糖尿病中的应用效果分析

目的探讨早期护理干预在妊娠期糖尿病中的应用效果。方法选取2021年6月—2023年5月荣成市人民医院收治的82例妊娠期糖尿病患者为研究对象,根据不同的护理方法分为研究组和对照组,各41例。研究组采用早期护理干预,对照组采用常规护理。比较两组空腹血糖水平、餐后2 h血糖水平、糖化血红蛋白水平、依从率、满意度、不良妊娠结局(产后出血、巨大儿、低体重儿)发生率。结果护理后,研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平分别为(5.78±0.62)mmol/L、(7.34±0.95)mmol/L、(6.08±0.74)%,均低于对照组的(7.05±0.91)mmol/L、(8.72±1.04)mmol/L、(7.61±0.85)%,差异有统计学意义(t=3.825、4.198、4.479,P均<0.05)。研究组依从率高于对照组,差异有统计学意义(P<0.05)。研究组满意度高于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率与不良妊娠结局发生率低于对照组,差异有统计学意义(P均<0.05)。结论妊娠期糖尿病患者运用早期护理干预,患者的血糖指标水平更低,满意度更高,依从性更好,并发症和不良妊娠结局发生率更低。

妊娠期糖尿病的影响因素及其与妊娠早期膳食铁摄入量的相关性

目的探究妊娠期糖尿病(GDM)发生的影响因素,并分析其与妊娠早期膳食铁摄入量相关性。方法选取1094例定期产检的孕妇作为研究对象,应用多因素Logistic回归模型分析GDM发生的影响因素,应用Pearson相关性分析研究GDM发生与妊娠早期膳食铁摄入量的相关性。结果1094例孕妇中,189例(17.28%)诊断为GDM。多因素Logistic回归模型分析结果显示,年龄≥35岁、孕前月经周期紊乱、膳食结构不均衡、妊娠早期膳食铁摄入量高和甘油三酯水平高均是孕妇发生GDM的危险因素(均P<0.05)。GDM的发生风险与妊娠早期膳食铁摄入呈正相关(r=0.537,P<0.001)。结论年龄≥35岁、孕前月经周期紊乱、膳食结构不均衡、妊娠早期膳食铁摄入量高和甘油三酯水平高均是孕妇发生GDM的危险因素,且GDM发生风险与妊娠早期妇女膳食铁摄入量呈正相关。

孕早期依据膳食评分实施营养干预对降低妊娠糖尿病发病率的影响

目的探讨分析孕早期按照膳食指南依从性指数评分对孕妇进行针对性营养干预对降低妊娠期糖尿病(GDM)发病率的影响。方法选择2022年9月至2023年6月在丹阳市妇幼保健院产科进行常规产检的妊娠期女性152例,随机分为研究组(99例)与对照组(53例)。对照组实施产科基础营养指导,研究组依据膳食指南依从性指数评分实施针对性营养干预。对比两组血糖、血脂相关指标、妊娠期糖尿病发生率。结果两组孕妇血糖、血脂相关指标对比,P>0.05。两组孕妇妊娠期糖尿病发病率对比,研究组显著低于对照组,P<0.05。结论孕早期按照膳食指南依从性指数评分对孕妇进行针对性营养干预可有效降低GDM发病风险,促进孕妇孕期健康。

妊娠糖尿病患者早孕期间相关因素同围产结局的Logistic多因素回归分析

目的探究妊娠期糖尿病(GDM)患者早孕期身体质量指数(BMI)增幅和24 h内葡萄糖在目标范围内时间与围产结局之间的关系。方法回顾性分析2019年10月至2021年10月期间,郑州市金水区总医院收治的妊娠期糖尿病患者共计188例,全部研究对象均在妊娠期早期接受体BMI、血糖水平的定期监测;查阅患者病历资料,根据围产结局将全部研究对象划分为顺利妊娠组(n=123)以及不良结局组(n=65);收集患者一般资料信息,记录孕早期BMI增幅、空腹血糖(FBG)、24 h内葡萄糖在目标范围内时间、糖化血红蛋白(HbA1c)水平。首先采用单因素Logistic回归分析探究可能影响妊娠期糖尿病者围产结局的相关因素,随后将组间差异存在统计学意义的因素纳入Logistic多因素分析,并探究引发GDM患者不良围产结局的独立危险因素。结果单因素回归分析结果显示,不良结局组产妇存在妊娠合并高血压、GDM家族史的病例数占比高于顺利妊娠组,差异有统计学意义(P<0.05);另外,不良结局组产妇的母血乳酸、孕早期BMI指数增幅、FBG以及HbA1c水平显著高于顺利妊娠组产妇、葡萄糖在目标范围内时间低于顺利妊娠组产妇,差异有统计学意义(P<0.05);多因素回归分析结果显示,早孕期BMI增幅偏高、孕妇FBG、HbA1c水平偏高、葡萄糖在目标范围内时间偏低是造成GDM产妇不良围产结局的独立危险因素,差异有统计学意义(P<0.05)。结论GDM患者孕早期BMI增幅以及葡萄糖水平在目标范围时间内与围产结局存在显著的相关性,BMI增幅偏高、葡萄糖在目标范围内时间偏低、空腹血糖以及糖化血红蛋白偏高是造成GDM产妇不良围产结局的独立危险因素。

早期综合护理干预对妊娠期糖尿病患者血糖控制效果的影响

目的研究早期综合护理干预应用于妊娠期糖尿病患者中的效果。方法选取88例妊娠期糖尿病患者,随机分为普通干预组(44例)及早期综合护理干预组(44例)。比较两组患者的干预效果。结果护理8周后,早期综合护理干预组空腹血糖、餐后2h血糖、糖化血红蛋白水平均更低,焦虑评分更低,生活质量评分更高(P<0.05)。早期综合护理干预组血糖控制效率优良率为95.46%,母婴并发症发生率为4.54%,均优于普通干预组的77.27%、22.73%(P<0.05)。结论将早期综合护理干预应用于妊娠期糖尿病患者中的效果理想,有助于更好地控制其血糖水平,减少母婴并发症发生。

妊娠期糖尿病患者妊娠早期TyG指数与分娩小于胎龄儿的相关性

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者妊娠早期甘油三酯葡萄糖指数(the triglyceride-gluscose index,TyG指数)与分娩小于胎龄儿(small for gestational age infant,SGA)之间的关系。方法选取2018年1月至2023年6月复旦大学附属上海市第五人民医院和新疆喀什地区第二人民医院产科孕早期建档并符合纳入标准的孕妇1532例为研究对象,根据孕妇24~28周行口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)结果,将其分为GDM组(754例)及非GDM组(778例)。GDM组患者根据新生儿体重,将其分为SGA组、大于胎龄儿(large for gestational age infant,LGA)组和适于胎龄儿(appropriate for gestational age infant,AGA)组。分析GDM患者分娩SGA的独立影响因素,采用Logistic回归模型分析TyG指数与发生SGA的相关性。绘制ROC曲线以分析妊娠早期TyG指数对GDM患者分娩SGA的预测价值。结果GDM患者SGA组TyG指数显著低于LGA组、AGA组及非GDM组(P<0.05);多因素Logistic回归分析结果显示,TyG指数与GDM患者分娩SGA的发生独立相关(P<0.05);ROC曲线结果显示,妊娠早期TyG指数对GDM患者分娩SGA具有较好的预测价值(AUC=0.821,95%CI:0.763~0.879,P<0.001)。结论GDM患者妊娠早期TyG指数与分娩SGA之间存在独立相关,对于GDM患者分娩SGA具有较好的预测价值。