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目的了解妊娠糖尿病(GDM)患者产后1年代谢综合征(MS)发病情况并分析影响因素。方法选择2009年1月至2012年6月于河北省沧州市中心医院GDM并于产后1年回访者126例(GDM组),选取同期分娩的糖代谢正常妇女并在产后1年应邀回访者114名为对照组(NGT组)。于孕中期收集孕前体重、糖尿病家族史、既往妊娠史等情况,并测量身高及体重,检测口服葡萄糖耐量试验(OGTT)各点血糖值、空腹胰岛素、空腹血脂,留置血清冰冻待测定高敏C反应蛋白(hs-CRP)。在产后1年进行随访,测量身高、体重、腹围、血压,检测空腹血糖、血脂。结果孕中期GDM患者较NGT组存在严重代谢紊乱,这种代谢紊乱在产后1年时仍持续存在;产后1年时GDM患者MS发病率为17.5%(22/126),对照组为7.9%(9/114)。Logistic回归分析显示产后发生MS的影响因素有OGTT时空腹血糖、孕前体重指数(BMI)、孕期hs-CRP及妊娠年龄,OR值分别为96.48、1.63、1.47及1.44。结论GDM患者产后MS发病率显著升高,其发生与孕期空腹血糖、孕前BMI、孕期hs-CRP及妊娠时年龄相关。
Objective To understand the incidence of metabolic syndrome (MS) in postpartum 1 year postpartum in gestational diabetes mellitus (GDM) and analyze the influencing factors. Methods 126 patients (GDM group) were interviewed in GDM of Cangzhou Central Hospital from January 2009 to June 2012 in Hebei Province. One hundred and eighty-six women with normal glucose metabolism and one year after delivery Namely control group (NGT group). During the second trimester, we collected the weight of pre-pregnancy, family history of diabetes and previous pregnancy history, measured the height and body weight, measured the blood sugar level, fasting insulin and fasting serum lipids in oral glucose tolerance test (OGTT) Protein (hs-CRP). One year postpartum, follow-up, height, weight, abdominal circumference, blood pressure, fasting blood glucose, blood lipids were measured. Results The second trimester GDM patients had severe metabolic disorder compared with that of NGT group. The metabolic disorder persisted at 1 year postpartum. The incidence of MS in GDM patients was 17.5% (22/126) at one year after birth and 7.9% 9/114). Logistic regression analysis showed that the influencing factors of postpartum MS were OGTT, FPG, BMI, gestational hs-CRP and gestational age. The OR values were 96.48, 1.63, 1.47 and 1.44 respectively. Conclusions The incidence of postpartum MS in GDM patients is significantly increased. The incidence of postpartum MS is related to fasting blood glucose during pregnancy, pre-pregnancy BMI, gestational hs-CRP and gestational age.