摘要
目的:分析妊娠期糖尿病(GDM)发生的影响因素及空腹C肽(FCP)、血脂、糖化血红蛋白(HbA1c)对GDM的预测价值。方法:以2020年6月—2023年6月本院收治的孕中期GDM患者82例为GDM组,产前检查健康孕妇88例为对照组。回顾性分析研究对象临床资料,logistic多因素回归分析GDM影响因素,以受试者特征工作特征(ROC)曲线分析FCP、血脂及HbA1c预测GDM价值。结果:GDM组孕前体质量指数、妊娠期糖尿病家族史、孕次、FCP、HbA1c、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组(均P<0.05),两组年龄、文化程度、家庭人均收入、高血压史、冠心病史、收缩压、舒张压比较差异不明显(P>0.05)。logistic多因素回归分析,孕前体质量指数≥25 kg/m^(2)、存在GDM家族史、孕次≥2次、FCP、HbA1c、TG、LDL-C升高是GDM独立危险因素(P<0.05);ROC曲线分析,FCP、HbA1c、LDL-C、TG联合预测GDM的曲线下面积为0.989,灵敏度为96.3%,特异性为96.6%,且优于各指标单独预测(P<0.05)。结论:GDM发生受多种因素的影响,包括孕前体质指数高、GDM家族史、孕次多,以及FCP、HbA1c、LDL-C、TG水平异常升高,孕早期测定上述4项指标可为GDM发生提供一定预测价值。
Objective:To analyze the influencing factors of the gestational diabetes mellitus(GDM)of pregnant women,and to study the prediction values of the levels of the fasting C-peptide(FCP),blood lipids and glycosylated hemoglobin(HbAlc)of the women for their GDM.Methods:82 pregnant women with GDM in the hospital from June 2020 to June 2023 were selected in the study group,and 88 healthy pregnant women who received prenatal examination in the hospital were included in the control group during the same period.The clinical data of the women in the two groups were analyzed retrospectively.Logistic multivariate regression analysis was used to analyze the influencing factors of the GDM occurrence of the women.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the levels FCP,blood lipid and HbAlc of the women for their GDM occurrence.Results:The pre-pregnancy body mass index value,the family history of GDM,the gravidity,and the levels of the FCP,HbAlc,total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)of the women in the study group were significantly higher than those of the women in the control group,and the high-density lipoprotein cholesterol(HDL-C)level of the women in the study group was significantly lower(all P<0.05).There were no significant differences in the age,the education level,the family per capita income,the history of hypertension,the history of coronary heart disease,and the values of systolic blood pressure and diastolic blood pressure of the women between the two groups(P>0.05).Logistic multivariate regression analysis showed that the pre-pregnancy body mass index≥25 kg/m^(2),the family history of GDM,the gravidity≥2 times,and the increased levels of FCP,HbAlc,TG and LDL-C of the women were the independent risk factors of their GDM occurrence(P<0.05).ROC curve analysis showed that the area under the curve,the sensitivity and the specificity of the combined levels of the FCP,HbAlc,LDL-C and TG of the women for predicting their GDM occurrence were 0.989,96.3%and 96.6%,respectively,which were significantly better than those of the FCP level,the HbAlc level,the LDL-C level or the TG level alone(P<0.05).Conclusion:The occurrence of GDM of the pregnant women is affected by many factors,including the high pre-pregnancy body mass index,the family history of GDM,the more gravidity,and the abnormal increase FCP,HbAlc,LDL-C and TG levels of the women,and the other factors.The determinations of the FCP,HbAlc,LDL-C and TG levels of the pregnant women during the first trimester of pregnancy can provide certain predictive value for the occurrence of their GDM.
作者
马云
赵超
齐保险
MA Yun;ZHAO Chao;QI Baoxian(Jieshou People's Hospital,Fuyang,Anhui Province,236500)
出处
《中国计划生育学杂志》
2025年第6期1410-1414,共5页
Chinese Journal of Family Planning
基金
2021年度安徽省卫生健康委科研项目(AHWJ2021b063)。
关键词
妊娠期糖尿病
空腹C肽
血脂水平
糖化血红蛋白
影响因素
预测价值
Gestational diabetes mellitus
Fasting C-peptide
Blood lipids
Glycosylated hemoglobin
Influencing factors
Predictive value
