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目的探讨妊娠期糖尿病孕妇(GDM)血清晚期糖基化终产物(AGEs)水平与新生儿心血管功能异常的关系。方法选择符合入选条件的妊娠中期GDM60例,妊娠晚期GDM72例。同期产科检查正常的妊娠中期孕妇72例,妊娠晚期孕妇80例。检测各组孕妇空腹血糖值、血清AGEs水平。收集GDM及其新生儿临床资料,根据新生儿心血管功能异常与否分为新生儿正常组和新生儿异常组,比较不同孕期2组孕妇血清AGEs、血糖水平的改变,以及2组新生儿的母亲血清AGEs水平。分析GDM新生儿心血管功能异常的危险因素。结果 1.无论妊娠中期还是妊娠晚期,GDM组孕妇血清AGEs水平、空腹血糖值均明显高于正常孕妇组(Pa<0.001,0.05)。2.同一GDM经干预治疗妊娠晚期时血糖明显降低(P<0.05);血清AGEs水平仍保持较高水平,妊娠中期与妊娠晚期比较差异无统计学意义(P>0.05)。3.新生儿异常组母亲血清AGEs水平明显高于新生儿正常组(P<0.05)。4.Logistic回归分析显示AGEs是GDM新生儿心血管功能异常的危险因子(OR=6.285,P<0.001,95%CI:2.561～15.524)。结论高AGEs血症是GDM新生儿心血管功能异常的危险因素之一,妊娠中晚期持续高水平AGEs可能是新生儿心血管功能异常发病率较高的原因之一。
Objective To investigate the relationship between the serum levels of advanced glycation end products (AGEs) and neonatal cardiovascular dysfunction in pregnant women with gestational diabetes mellitus (GDM). Methods Sixty-six pregnant women with GDM during the second trimester of pregnancy and 72 GDM patients during the third trimester of pregnancy were enrolled in this study. Obstetric examination during the same period of normal mid-pregnancy 72 pregnant women, pregnant women in late pregnancy 80 cases. The fasting blood glucose and serum AGEs in each group were detected. The clinical data of GDM and its neonate were collected and divided into normal newborn group and abnormal newborn group according to whether newborns had abnormal cardiovascular function or not. The levels of serum AGEs and blood glucose in two groups of pregnant women were compared, Maternal serum AGEs levels. To analyze the risk factors of neonatal cardiovascular dysfunction in GDM. Serum AGEs level and fasting blood glucose level in pregnant women with GDM group were significantly higher than those in normal pregnant women (Pa <0.001,0.05), no matter in the second trimester of pregnancy or in the third trimester of pregnancy. The same GDM intervention in the treatment of late pregnancy significantly lower blood glucose (P <0.05); serum AGEs levels remained at high levels, the second trimester of pregnancy compared with late pregnancy was no significant difference (P> 0.05). The level of AGEs in mothers with abnormal neonates was significantly higher than that in normal neonates (P <0.05). Logistic regression analysis showed that AGEs were risk factors for cardiovascular dysfunction in neonates with GDM (OR = 6.285, P <0.001, 95% CI: 2.561-15.524). Conclusions High AGEs hyperlipidemia is one of the risk factors of neonatal cardiovascular dysfunction in GDM. Sustained high levels of AGEs in the second and third trimester of pregnancy may be one of the reasons for the higher incidence of cardiovascular dysfunction in neonates.