妊娠期糖尿病患者发病的危险因素及炎性应激状态分析

Analysis of risk factors for occurrence of gestational diabetes mellitus in patients and inflammatory stress status

  • 摘要:
    目的 分析孕晚期妊娠期糖尿病(GDM)发病的危险因素,并探讨GDM孕妇炎性应激状态与妊娠结局的相关性。
    方法 选取87例孕晚期GDM孕妇作为GDM组,另选取同期87例无GDM的孕晚期孕妇作为非GDM组。通过单因素分析比较GDM组与非GDM组孕妇的临床资料,并通过二元Logistic回归分析探讨GDM发病的危险因素; 采用Spearman相关性分析探讨GDM孕妇炎性应激状态与妊娠结局的相关性。
    结果 单因素分析结果显示,与非GDM组比较, GDM组年龄、孕期增重≥15 kg者占比、有不良孕产史者占比、有糖尿病家族史者占比、有妊娠高血压者占比、有孕期贫血者占比、有阴道念珠菌感染者占比、喜食甜食者占比更高,日运动时间≥1 h者占比更低,差异有统计学意义(P < 0.05)。二元Logistic回归分析结果显示,年龄较大、孕期增重≥15 kg、不良孕产史、糖尿病家族史、妊娠高血压、孕期贫血、喜食甜食是孕晚期GDM发病的独立危险因素(P < 0.05), 日运动时间≥1 h是独立保护因素(P < 0.05)。与不良妊娠结局孕妇相比,良好妊娠结局孕妇的C反应蛋白(CRP)、淋巴细胞(LYM)、中性粒细胞(NEUT)、降钙素原(PCT)和白细胞(WBC)水平更高,差异有统计学意义(P < 0.05)。Spearman相关性分析结果显示,炎性应激状态指标CRP、LYM、NEUT、PCT及WBC水平与GDM孕妇不良妊娠结局风险均呈正相关(P < 0.05)。
    结论 孕晚期GDM的发病与孕妇年龄、孕期增重、不良孕产史、糖尿病家族史、妊娠高血压、孕期贫血、喜食甜食及日运动时间有关,且孕晚期GDM患者的炎性应激状态与妊娠不良结局密切相关。

     

    Abstract:
    Objective To analyze the risk factors for gestational diabetes mellitus (GDM) in late pregnancy and explore the correlation between inflammatory stress status and pregnancy outcomes in GDM pregnant women.
    Methods A total of 87 pregnant women with GDM in late pregnancy were selected as GDM group, and another 87 pregnant women without GDM during the same period were selected as non-GDM group. Univariate analysis was conducted to compare the clinical data between the GDM group and the non-GDM group, and binary Logistic regression analysis was used to explore the risk factors for GDM. Spearman correlation analysis was employed to investigate the correlation between inflammatory stress status and pregnancy outcomes in GDM pregnant women.
    Results Univariate analysis showed that compared with the non-GDM group, the GDM group had a higher proportion of women who were older, had a weight gain of ≥15 kg during pregnancy, a history of adverse pregnancy outcomes, a family history of diabetes, gestational hypertension, anemia during pregnancy, vaginal candidiasis infection, a preference for sweet foods, and a lower proportion of women engaging in daily exercise for ≥1 h(P < 0.05). Binary Logistic regression analysis revealed that older age, weight gain of ≥15 kg during pregnancy, history of adverse pregnancy outcomes, family history of diabetes, gestational hypertension, anemia during pregnancy and preference for sweet foods were independent risk factors for GDM in late pregnancy (P < 0.05), while daily exercise for ≥1 h was an independent protective factor (P < 0.05). Compared with pregnant women with adverse pregnancy outcomes, women with favorable pregnancy outcomes had higher levels of C-reactive protein (CRP), lymphocytes (LYM), neutrophils (NEUT), procalcitonin (PCT) and white blood cells (WBC) (P < 0.05). Spearman correlation analysis showed that the levels of inflammatory stress indicators such as CRP, LYM, NEUT, PCT and WBC were positively correlated with the risk of adverse pregnancy outcomes in GDM pregnant women (P < 0.05).
    Conclusion The incidence of GDM in late pregnancy is associated with maternal age, weight gain during pregnancy, history of adverse pregnancy outcomes, family history of diabetes, gestational hypertension, anemia during pregnancy, preference for sweet foods and daily exercise time. Moreover, the inflammatory stress status of GDM patients in late pregnancy is closely related to adverse pregnancy outcomes.

     

/

返回文章
返回