| 卢永军,赵志玲,焦钰洁,等.多囊卵巢综合征 337例发生妊娠期糖尿病的高危因素分析[J].安徽医药,2023,27(6):1188-1191. |
| 多囊卵巢综合征 337例发生妊娠期糖尿病的高危因素分析 |
| Analysis of risk factors for gestational diabetes mellitus in 337 cases of polycystic ovary syndrome |
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| DOI：10.3969/j.issn.1009-6469.2023.06.029 |
| 中文关键词: 多囊卵巢综合征 危险因素 妊娠期糖尿病 孕前体质量指数 糖化血红蛋白 空腹血糖 |
| 英文关键词: Polycystic ovary syndrome Risk factors Gestational diabetes mellitus Prepregnancy body mass index Glycated hemoglobin Fasting blood glucose |
| 基金项目:中国疾病预防控制中心妇幼保健中心母婴营养与健康研究项目资助( 2021FY017) |
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| 中文摘要: |
| 目的探究多囊卵巢综合征( PCOS)孕妇发生妊娠期糖尿病( GDM)的危险因素。方法回顾性分析 2015年 1月至 2020年 12月在北京市通州区妇幼保健院建档并住院分娩的 337例 PCOS孕妇的临床资料，根据是否合并 GDM分为 PCOS组 221例， GDM组 116例。比较两组的年龄、文化程度、妊娠方式、孕产次、糖尿病家族史、孕前体质量指数( BMI)、孕早期糖化血红蛋白( HbA1c)、糖化白蛋白及血生化指标等。结果 GDM组孕前 BMI(25.58±4.27)kg∕m2比( 23.22±3.54)kg∕m2)、孕早期 HbA1c(5.277±0.301)%比( 5.095±0.290)%、空腹血糖( FPG)(5.286±0.379)mmol/L比( 5.006±0.330)mmol/L、均明显高于 PCOS组，差异有统计学意义( P<0.05)。 logistic回归分析提示孕前 BMI［OR=1.13，95%CI:(1.05，1.20)］、孕早期 HbA1c［OR=2.76， 95%CI:(1.10，6.95)］、 FPG［OR=6.86，95%CI:(3.19，14.77)］是 GDM发生的独立危险因素。经受试者操作特征( ROC)曲线分析，孕前 BMI、孕早期 HbA1c、FPG单项及三者联合预测 GDM的曲线下面积( AUC)分别为 0.67、0.68、0.72、0.78，三者联合对 GDM的预测价值最高。孕前 BMI、孕早期 HbA1c、FPG预测 GDM的截点值分别为 23.98 kg/m2、5.15%、5.14 mmol/L。结论 PCOS孕妇孕前 BMI、孕早期 HbA1c和 FPG较高时，容易发生 GDM。建议 PCOS女性孕前适当减重，孕早期监测并控制 HbA1c和 FPG在适当范围，以期减少 GDM的发生。 |
| 英文摘要: |
| Objective To explore the risk factors for gestational diabetes mellitus (GDM) in pregnant women with polycystic ovary syndrome (PCOS).Methods The clinical data of 337 pregnant women with PCOS who were recorded and delivered inpatiently at Tongzhou District Maternal and Child Health Hospital in Beijing from January 2015 to December 2020 were retrospectively analyzed, andwere divided into the PCOS group (221 cases) and the GDM group (116 cases) according to whether they had GDM in combination.Age, education, pregnancy type, pregnancy and delivery, family history of diabetes, prepregnancy body mass index (BMI), early pregnancy glycated hemoglobin (HbA1c), glycated albumin and blood biochemical indexes were compared between the two groups. Re? sults The prepregnancy BMI (25.58±4.27) kg∕m2 vs. (23.22±3.54) kg∕m2, HbA1c (5.277±0.301) % vs. (5.095±0.290) % and fasting plasma glucose (FPG) (5.286±0.379) mmol/L vs. (5.006±0.330) mmol/L were significantly higher than those in the PCOS group, with statistically significant differences (P<0.05). Logistic regression analysis indicated that prepregnancy BMI [OR=1.13, 95% CI: (1.05, 1.20)], HbA1c [OR=2.76, 95%CI: (1.10, 6.95)] and FPG [OR=6.86, 95%CI: (3.19, 14.77)] were independent risk factors for the development of GDM. By receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) of prepregnancy BMI, earlypregnancy HbA1c, and FPG alone and the combination of the three predicted GDM were 0.67, 0.68, 0.72, and 0.78, respectively, andthe combination of the three had the highest predictive value for GDM. The cutoff values of prepregnancy BMI, early pregnancy HbA1c,and FPG for predicting GDM were 23.98 kg/m2, 5.15%, and 5.14 mmol/L, respectively.Conclusions Pregnant women with PCOS areprone to GDM when their prepregnancy BMI, early pregnancy HbA1c and FPG are high. It is recommended that women with PCOS loseweight appropriately before pregnancy and monitor and control HbA1c and FPG in the appropriate range in early pregnancy to reducethe occurrence of GDM. |
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