| 孕早期血红蛋白水平与妊娠期糖尿病的关系研究:基于出生人口队列 |
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| 引用本文： | 闫明鑫,赵豆豆,宛惠玲,赵欢,单莉,裴磊磊,米阳,屈鹏飞. 孕早期血红蛋白水平与妊娠期糖尿病的关系研究:基于出生人口队列[J]. 中华疾病控制杂志, 2023, 27(1): 60-64. DOI: 10.16462/j.cnki.zhjbkz.2023.01.011 |
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| 作者姓名： | 闫明鑫 赵豆豆 宛惠玲 赵欢 单莉 裴磊磊 米阳 屈鹏飞 |
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| 作者单位： | 1.710061 西安，西安交通大学医学部附属西北妇女儿童医院 |
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| 基金项目： | 国家重点研发计划2016YFC1000101国家自然科学基金82103924国家自然科学基金72174167西安市科技计划20YXYJ0005(8) |
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| 摘 要： | 目的 探究中国西北地区孕妇孕早期血红蛋白水平与妊娠期糖尿病(gestational diabetes mellitus, GDM)的关系。 方法 连续纳入2018年7月-2019年7月加入西北妇女儿童医院出生人口队列的孕早期孕妇，调查其基本人口学特征、生活行为方式等资料，并对研究对象的孕早期血红蛋白水平、口服葡萄糖耐量试验(oral glucose tolerance test, OGTT)结果进行随访。首先使用logistic回归分析模型分析孕早期血红蛋白水平对GDM的影响，进一步采用限制性三次立方样条来呈现血红蛋白水平与GDM的非线性关系。 结果 在调整了混杂因素后，孕早期高血红蛋白水平(血红蛋白≥135 g/L)增加了GDM的发生风险(OR=1.44，95% CI:1.13~1.83)；孕早期血红蛋白水平每升高10 g/L，FPG、OGTT 1h血糖、OGTT 2h血糖水平分别升高0.03 mmol/L(95% CI:0.01~0.05)、0.14 mmol/L(95% CI:0.07~0.21)、0.13 mmol/L(95% CI:0.08~0.19)；限制性立方样条结果显示，随着孕早期血红蛋白水平升高，GDM的发生风险逐渐升高。 结论 孕早期血红蛋白水平升高将增加GDM的发病风险，应积极对孕妇孕早期血红蛋白水平进行监测，促进母婴健康。
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| 关 键 词： | 妊娠期糖尿病 孕早期 血红蛋白水平 口服葡萄糖耐量试验 |
| 收稿时间： | 2022-03-30 |
Relationship between hemoglobin level in early pregnancy and gestational diabetes mellitus: a birth cohort study |
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| Affiliation: | 1.Northwest Women and Children's Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710061, China2.Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China |
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| Abstract: | Objective To investigate the relationship between hemoglobin levels in early pregnancy and gestational diabetes mellitus (GDM) in pregnant women in northwest China. Methods In Northwest Women's and Children's Hospital from July 2018 to July 2019, women in early pregnancy were recruited to birth cohort. A questionnaire was used to collect their basic demographic characteristics and lifestyle behaviors, and to follow up the hemoglobin levels and oral glucose tolerance test (OGTT) in early pregnancy. The association of hemoglobin levels in early pregnancy with GDM was first explored using a logistic regression model, and the nonlinear relationship between hemoglobin levels and GDM was further investigated by restricted cubic splines. Results After adjusting for confounders, high hemoglobin levels (Hb ≥135 g/L) in early pregnancy increased the risk of GDM (OR=1.44, 95% CI: 1.13-1.83). For every 10g/L increase in hemoglobin levels in early pregnancy, FPG, OGTT 1h glucose, and OGTT 2h glucose levels increased by 0.03 mmol/L (95% CI: 0.01-0.05), 0.14 mmol/L (95% CI: 0.07-0.21), and 0.13 mmol/L (95% CI: 0.08-0.19), respectively. The results of the restricted cubic strip showed that the risk of GDM progressively increased with increasing hemoglobin levels in early pregnancy. Conclusions Elevated hemoglobin levels in early pregnancy will increase the risk of GDM. Women hemoglobin levels in early pregnancy should be actively monitored to promote maternal and infant health. |
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