摘要
目的 探讨北京地区孕期糖代谢异常患者产后1年糖、脂代谢的转归.方法 2007年2月至12月于本院分娩,并分别于产后6～12周及产后1年于本院复诊的患者73例,年龄（32.0±3.6）岁.妊娠糖尿病46例（63％）,妊娠期糖耐量受损（GIGT）27例（37％）.所有患者均就诊于妊娠糖尿病产后随访门诊,分别于产后6～12周及产后1年进行随访.了解体重变化,测量腰围、臀围,行口服葡萄糖耐量试验（OGTT）及血月脂检测.结果 与产后6～12周相比,产后1年体重、腰围、臀围及腰臀比均出现有下降.产后1年与产后6～12周比较,空腹血糖（5.19±0.06）对（4.84±0.57） mmol/L（P＜0.01）,6～12周无空腹血糖受损（IFG）,1年后出现4例IFG;餐后血糖（6.84±1.93）对（7.33±1.50） mmol/L（P=0.017）,糖耐量受损（IGT）发生率28.8％对38.4％ （P=0.167）,其中6例6～12周餐后血糖正常者1年后出现IGT.与6 ～12周相比,产后1 年高甘油三酯血症更多（19.2％对13.7％）,高胆固醇血症减少（19.7％对30.0％,P＜0.01）,低高密度脂蛋白胆固醇（HDL-C）血症显著增加（21.9％对4.1％,P＜0.01）,高低密度脂蛋白胆固醇（LDL-C）血症减少（21.9％对49.3％,P＜0.01）. 无沦是产后6～12周或产后1年,妊娠期糖耐量受损及妊娠糖尿病两组间体重、体重指数、腰围、臀围及腰臀比均未见明显差异.结论 妊娠糖尿病是育龄女性糖尿病患病率增加的重要原因.在体重、腰臀比等指标显著改善的情况下,妊娠糖尿病患者产后1年仍存在普遍的糖、脂代谢异常.
Objective To elaborate the glucose and lipid metabolism 1 year postpartum on the foundation of postpartum 6-12 weeks in patients with prior gestational abnormal glucose metabolism in Beijing area.Methods Seventy-three patients who delivered during February to December,2007,aged （32.0 ± 3.6） years,were enrolled.46 cases （63％） were diagnosed as cases of gestational diabetes mellitus （GDM） while 27 （37％） as gestational impaired glucose tolerance （GIGT）.All of the patients were revisited twice by 6-12 weeks and 1 year postparaum.Body weight,waist andhip circumferences,oral glucose tolerance test（OGTT）,and lipids profile were determined.Results Compared with 6-12 weeks postpartum,the body weight,waist and hip circumferences,and waist-to-hip ratio were decreased by 1 year postpartum,fasting plasma glucose was increased [（5.19 ± 0.06） vs （4.84 ± 0.57） mmol/L,P＜0.01],and 4 cases were diagnosed as cases with impaired fasting glucose （IFG; 4 vs 0）.By 6-12 weeks and 1 year postpartum,postprandial plasma glucose levels were （6.84± 1.93） and （7.33 ± 1.50） mmol/L（P=0.017）,and the incidences of impaired glucose tolerance（IGT） were 28.8％ and 38.4％ （P=0.167）,respectively,with 6 cases of newly diagnosed IGT by 1 year postpartum.There were more cases of hypertriglyceridenia （19.2％ vs 13.7％）,less cases of hypercholesterolemia（19.7％ vs 30.0％,P＜0.01）,more cases with improved high-densit.y lipoprotein-cholesterol （21.9％ vs 4.1％,P＜0.01）,and less cases with raised low-density lipoproteincholesterol（21.9％ vs 49.3％,P＜0.01）.No difference was found in body weight,body mass index,waist circumference,hip circumference,and waist-to-hip ratio between GIGT and GDM groups.Conclusion GDM is an important cause of the increasing prevalence of diabetes in women of reproductive age.Although body weight and waist-to-hip ratio have been improved,they would still develop glucose intolerance and dyslipidemia 1 year postpartum.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2014年第6期477-481,共5页
Chinese Journal of Endocrinology and Metabolism
关键词
糖尿病
妊娠
糖尿病
2型
产后
Diabetes mellitus, gestational
Diabetes mellitus, type 2
Postpartum
