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目的 探讨妊娠期糖尿病高危孕妇孕前体质指数(body mass index, BMI)与孕早期糖脂代谢之间的关联。方法 收集2021年8月—2022年4月在北京市海淀区妇幼保健院营养科就诊的具有妊娠期糖尿病高危因素的孕早期孕妇298例，平均年龄(32.24±4.04)岁，66.11%为初产妇，采血时间平均为孕12.5周。按照孕前BMI将孕妇分为低体重组(15例)、正常体重组(181例)、超重/肥胖组(102例)。比较各组孕妇空腹血糖、空腹胰岛素、血脂四项、C反应蛋白、瘦素与脂联素水平。结果 (1)孕前超重/肥胖组孕妇孕早期甘油三酯浓度明显高于低体重组(1.51 mmol/L vs. 1.15 mmol/L)(P<0.01),高密度脂蛋白胆固醇水平低于低体重组(1.64 mmol/L vs. 1.95 mmol/L)(P<0.01)。(2)孕前低体重组妇女孕早期胰岛β细胞功能降低，HOMA-β指数为60.41%,超重/肥胖组妇女孕早期空腹胰岛素水平(7.86 vs. 3.42μU/mL)、胰岛素抵抗程度(1.75 vs. 0.74)高于低体重组(P<0.01)。(3)孕妇孕前BMI与孕早期甘油三酯、C反应蛋白、空腹胰岛素、胰岛素抵抗程度呈正相关(r=0.30、0.28、0.45、0.45,P<0.01),与孕早期高密度脂蛋白胆固醇水平呈负相关(r=-0.29,P<0.01)。结论 在具有妊娠期糖尿病高危因素的孕妇中，孕前超重肥胖与妊娠早期糖脂代谢水平存在关联。
Abstract：OBJECTIVE To examine the association of pre-pregnancy body mass index(BMI) and first-trimester glucose and lipid metabolism.METHODS A total of 298 pregnant women with high risk factors for gestational diabetes in early pregnancy, with an average age of 32.24 years, 66.11% were primiparous and the average time for blood collection was 12.5 weeks, were collected from August 2021 to April 2022 at the Department of Nutrition, Haidian District Maternal and Child Health Hospital, Beijing. Pregnant women were divided into low weight group(n=15), normal weight group(n=181), overweight/obese group(n=102) according to their pre-pregnancy BMI. Fasting glucose, fasting insulin, lipid quadruple, C-reactive protein, leptin and adiponectin levels were compared among groups.RESULTS(1)Triglyceride concentrations were significantly higher in women in the overweight/obese group(1.51 mmol/L vs. 1.15 mmol/L) than in women in low weight group(P<0.01).HDL cholesterol(HDL-C) levels were lower than in women with low weight(1.64 mmol/L vs. 1.95 mmol/L)(P<0.01).(2)Pre-pregnancy low weight women had reduced pancreatic β-cell function in early pregnancy with the HOMA-β index of 60.41%, and women in the overweight/obese group had heavier fasting insulin levels(7.86 vs. 3.42 μU/mL) and insulin resistance(1.75 vs 0.74) in early pregnancy than low weight women(P<0.01).(3)Pre-pregnancy BMI was positively correlated with triglycerides, fasting insulin, C-reactive protein levels, and degree of insulin resistance in early pregnancy(r=0.30, 0.28, 0.45 and 0.45,P<0.01)and negatively correlated with HDL-C levels in early pregnancy(r=-0.29,P<0.01).CONCLUSION Among pregnant women with risk factors for gestational diabetes, pre-pregnancy overweight and obesity are associated with glucose and lipid metabolism levels in early pregnancy.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2023.02.004
中图分类号:R714.256
引用信息:
[1]杨旭博,滕越,姜珊,等.妊娠期糖尿病高危孕妇孕前体质指数与孕早期糖脂代谢的关系[J].卫生研究,2023,52(02):193-197+212.DOI:10.19813/j.cnki.weishengyanjiu.2023.02.004.
基金信息:
中国营养学会“振东国人体质与健康基金”(No.CNS-ZD2019079)
2022-10-19
2022
2023-05-09
2023
1
2023-03-16
2023-03-16