摘要
目的分析体成分与妊娠期糖尿病(gestational diabetes mellitus, GDM)发生关系及影响因素, 为GDM的防治措施提供基础资料。方法选择孕24~28周GDM孕妇1 553例(GDM组), 将同期同孕期糖耐量正常(normal glucose tolerance, NGT)孕妇1 298例作为对照组, 收集两组患者一般资料、体成分检测资料、75 g口服葡萄糖耐量试验结果进行统计分析。呈正态分布的计量资料组间比较采用t检验, 计数资料比较χ^(2)检验。结果 GDM组年龄(31.30±4.63)岁、孕前体质量指数(21.78±3.11)kg/m^(2)、体脂肪含量占比(30.77±5.26)%, 均高于NGT组[(28.42±4.01)岁、(20.74±3.04)kg/m^(2)、(27.76±5.56)%];体内水含量占比(50.46±4.11)%、蛋白质含量占比(13.91±1.27)%、无机盐含量占比(4.90±1.99)%, 均低于NGT组[(52.11±3.97)%、(14.47±1.18)%、(5.71±2.26)%], 两组间比较差异均有统计学意义(t值分别为17.84、9.03、6.41、8.67、7.14、5.94, 均P<0.001);GDM组高龄(25.4%, 394/1 553)、糖尿病家族史(23.1%, 359/1 553)、GDM史(4.3%, 67/1 553)、多囊卵巢综合征史(0.6%, 9/1 553)检出率均高于NGT组[7.4%(96/1 298)、11.4%(148/1 298)、0.3%(4/1 298)、0.1%(1/1 298)], 两组间比较差异均有统计学意义(χ^(2)值分别为160.49、66.36、46.73、5.11, 均P<0.05);GDM组孕前体质量指数为消瘦、正常、超重、肥胖人群的占比分别为11.5%(179/1 553)、65.8%(1 022/1 553)、18.5%(287/1 553)、4.2%(65/1 553), NGT组分别为22.6%(293/1 298)、63.0%(818/1 298)、11.4%(148/1 298)、3.0%(39/1 298);GDM组体脂肪含量偏低、正常、偏高分别为1.9%(30/1 553)、45.5%(707/1 553)、52.6%(817/1 553), NGT组分别为例8.1%(105/1 298)、54.0%(701/1 298)、37.9%(492/1 298);GDM组蛋白质含量偏低、正常、偏高分别为95.9%(1489/1 553)、4.1%(64/1 553)、0(0/1 553), NGT组分别为89.5%(1162/1 298)、10.5%(136/1 298)、0(0/1 298);GDM组水含量偏低、正常、偏高分别为36.3%(564/1 553)、54.3%(843/1 553)、9.4%(146/1 553), NGT组分别为22.5%(292/1 298)、58.8%(763/1 298)、18.7%(243/1 298);两组人群孕前体质量指数及体内水、体脂肪、蛋白质含量总体分布差异均有统计学意义(统计量值分别为78.89、92.53、100.21、43.80, 均P<0.001);Logistic分析显示, 高龄(OR=3.462, 95%CI=2.737~4.380)、孕前超重(OR=1.296, 95%CI=1.031~1.628)、糖尿病家族史(OR=2.061, 95%CI=1.676~2.535)、GDM史(OR=12.688, 95%CI=4.577~35.169)、体脂肪含量偏高(OR=1.607, 95%CI=1.234~2.092)、水含量偏低(OR=1.493, 95%CI=1.025~2.175)是GDM的危险因素(均P<0.05);体脂含量偏低(OR=0.341, 95%CI=0.151~0.768)是GDM的保护因素(P<0.05)。结论除孕前体质量指数、高龄、糖尿病家族史、GDM史等传统危险因素, 体内水、体脂肪含量在GDM的发生中也起到重要作用。
Objective To analyze the body composition and determinants of gestational diabetes mellitus(GDM),so that to provide basic data for prevent and control GDM further.Methods All 1553 pregnant women with GDM(GDM group)at 24-28 weeks of gestation were selected,and 1298 pregnant women with normal glucose tolerance(NGT)at the same pregnancy were taken as the control group.The general data,body composition test data and 75 g oral glucose tolerance test results of the two groups were collected for statistical analysis.T-test was used for comparison between normal distribution measurement data groups,and counting data were comparedχ^(2) inspection.Results The age of GDM group(31.30±4.63)years,the body mass index before pregnancy(21.78±3.11)kg/m^(2),and the proportion of body fat content(30.77±5.26)%were all higher than that of NGT Group((28.42±4.01)years,(20.74±3.04)kg/m^(2),(27.76±5.56)%).The proportion of water content(50.46±4.11)%,protein content(13.91±1.27)%,and inorganic salt content(4.90±1.99)%,were lower than that of NGT Group((52.11±3.97)%,(14.47±1.18)%,(5.71±2.26)%),and there were significant differences between the two groups(t values were 17.84,9.03,6.41,8.67,7.14 and 5.94,respectively;all P<0.001).The detection rates of advanced age 25.4%(394/1553),family history of diabetes 23.1%(359/1553),history of GDM 4.3%(67/1553),history of polycystic ovary syndrome 0.6%(9/1553)in GDM group were higher than those in NGT group(7.4%(96/1298),11.4%(148/1298),0.3%(4/1298),0.1%(1/1298)).There were statistically significant differences between the two groups(χ^(2) values were 160.49,66.36,46.73 and 5.11,respectively;all P<0.05).The proportion of lean,normal,overweight and obese people in GDM group was 11.5%(179/1553),65.8%(1022/1553),18.5%(287/1553),4.2%(65/1553),and 22.6%(293/1298),63.0%(818/1298),11.4%(148/1298),3.0%(39/1298),respectively.The body fat content in GDM group was 1.9%(30/1553),45.5%(707/1553),52.6%(817/1553),and 8.1%(105/1298),54.0%(701/1298),and 37.9%(492/1298),respectively.The protein content in GDM group was 95.9%(1489/1553),4.1%(64/1553),0(0/1553),and 89.5%(1162/1298),10.5%(136/1298),0(0/1298),respectively.The low,normal and high water content in GDM group were 36.3%(564/1553),54.3%(843/1553),9.4%(146/1553),and 22.5%(292/1298),58.8%(763/1298),18.7%(243/1298),respectively.There were statistically significant differences in the overall distribution of body mass index before pregnancy and the contents of body water,body fat and protein between the two groups(statistical values were 78.89,100.21,43.80 and 92.54,all P<0.001).Logistic analysis showed that old age(OR=3.462,95%CI=2.737-4.380),overweight before pregnancy(OR=1.296,95%CI=1.031-1.628),family history of diabetes(OR=2.061,95%CI=1.676-2.535),history of GDM(OR=12.688,95%CI=4.577-35.169),high body fat content(OR=1.607,95%CI=1.234-2.092),low water content(OR=1.493,95%CI=1.025-2.175)were the risk factors of GDM(all P<0.05).Low body fat content(OR=0.341,95%CI=0.151-0.768)was the protective factor of GDM(P<0.05).Conclusions In addition to the traditional risk factors such as body mass index before pregnancy,old age,family history of diabetes,and history of GDM,the contents of body water and body fat also played an important role in the occurrence of GDM.
作者
邓炳俊
陈文英
刘丹
Deng Bingjun;Chen Wenying;Liu Dan(Department of Women's Insurance,Longgang District Maternity and Child Healthcare Hospital of Shenzhen,Guangdong Province,Shenzhen 518100,China;Department of Women's group health,Longgang District Maternity and Child Healthcare Hospital of Shenzhen,Guangdong Province,Shenzhen 518100,China)
出处
《中国综合临床》
2022年第5期455-460,共6页
Clinical Medicine of China
关键词
妊娠期糖尿病
体成分
影响因素
Gestational Diabetes Mellitus
Body composition
Influence factor
