妊娠期糖尿病相关因素的Meta分析

目的:探讨妊娠期糖尿病(GDM)与部分相关因素的关系。方法:通过中国期刊全文数据库、中国生物医学文献数据库、HighWire Press、Medline等数据库收集1995年至2011年国内外公开发表的关于GDM相关因素的文献,采用Meta分析综合定量分析最终纳入的文献。结果:糖尿病家族史(合并OR为2.84,95%CI为1.95～4.15),超重或肥胖(合并OR为2.23,95%CI为1.90～2.61),年龄(合并OR为2.97,95%CI为2.28～3.89),肿瘤坏死因子α基因启动子308位点(TNF-α-308)G/A基因多态性(GA+AA基因型合并OR为3.69,95%CI为2.52～5.36;携带A等位基因合并OR为3.40,95%CI为2.56～4.53),糖化血红蛋白(HbA1c)含量(合并OR为84.43,95%CI为17.01～418.96),不良孕产史(合并OR为1.90,95%CI为1.55～2.34),吸烟(合并OR为2.23,95%CI为1.16～4.28),体育锻炼(合并OR为0.69,95%CI为0.49～0.96),种族差异(白色人种合并OR为0.62,95%CI为0.53～0.74,黄色人种合并OR为2.58,95%CI为1.90～3.50),上述因素均为GDM相关因素。文化程度和非洲裔美国人的合并结果无统计学差异(P>0.05)。结论:糖尿病家族史、超重或肥胖、年龄(≥25岁)、TNF-α-308携带A等位基因、不良孕产史和吸烟均为GDM危险因素,体育锻炼为其保护因素;种族差异可能是造成对GDM敏感性不同的影响因素之一;作为判定血糖长期控制情况的良好指标,糖化血红蛋白为妊娠期糖尿病的筛查和诊断提供了新途径和新方法。     

妊娠期糖尿病并发脂代谢紊乱的危险因素

目的:分析妊娠期糖尿病(GDM)并发脂代谢紊乱的危险因素.方法:回顾分析合肥市第三人民医院妇产科2016年2月～2018年5月收治的300例GDM患者的资料,统计脂代谢紊乱发生率和妊娠结局,分析发生脂代谢紊乱的危险因素.结果:脂代谢紊乱发生率为25.33％(76/300).GDM并发脂代谢紊乱组的母体、围产儿不良妊娠结...     

月经不调--妊娠期糖尿病可能的危险因素

妊娠期糖尿病(GDM)的高危因素包括：一级亲属患糖尿病、非白人种、巨大儿分娩史、不良孕产史、肥胖、高龄孕妇及PCOS等。目前一项研究表明：月经不调(常用作P—COS的代名词)也可能是GDM的高危因素之一。     

妊娠期糖尿病危险因素的Logistic回归模型初探

目的:新诊断标准下,调查分析妊娠期糖尿病(GDM)的相关因素,建立临床评分体系,初步构建GDM危险因素Logistic回归模型。方法:按2010年国际妊娠合并糖尿病研究组织(IADPSG)推荐的GDM的新诊断标准,通过病例-对照研究分析GDM发生的影响因素,建立Logistic回归模型,采用接受者工作特征曲线(ROC)和Hosmer-Lemeshow拟合优度检验评价模型。结果:妊娠年龄、孕前体重指数(BMI)、孕期补铁、糖尿病(DM)家族史、多囊卵巢综合征(PCOS)史、孕期锻炼6项因素进入回归模型。当累积分值达到6.3分时,Youden指数最大,为0.640,此时灵敏度为83.4%,特异度为80.6%,阳性预测值为81.0%,阴性预测值为83.1%,诊断准确度为82.0%。ROC曲线下面积为0.875。Hosmer-Lemeshow拟合优度检验P=0.91。结论:妊娠年龄、孕前BMI、孕期补铁、糖尿病家族史、PCOS是GDM发生的危险因素,而孕期锻炼是GDM的保护因素,初步构建了一种简便易行且具有较高诊断效能的回归模型。     

昆明地区妊娠期糖尿病发生的母亲人口统计学和社会危险因素

目的:调查中国昆明地区妊娠期糖尿病(GDM)孕妇的人口统计学和社会危险因素。方法:对2004年1月至2009年12月期间在昆明一所三甲教学医院和两家民营医院接受75g口服葡萄糖耐量试验(OGTT)的8538例单胎孕妇进行前瞻性研究。结果:研究期间该地区GDM的总体发生率为12.5%(IGT 11.7%,GDM 0.8%);孕妇受教育程度最高组(硕士及以上)GDM的发生率最高(16.4%),显著高于大学大专组(16.4%vs12.8%,P=0.036)、高中中专组(16.4%vs 12.4%,P=0.028)和初中及以下组(16.4%vs 10.9%,P=0.002)。多元Logistic回归显示孕妇年龄(OR=1.61,95%CI 1.42～1.83,P=0.000),OGTT时体重指数(OR=1.15,95%CI 1.11～1.20,P=0.000),一级亲属糖尿病(DM)家族史(OR=1.96,95%CI 1.45～2.64,P=0.000),受教育程度(OR=1.16,95%CI 1.02～1.35,P=0.047)是发生GDM的独立危险因素。结论:昆明地区研究期间妊娠期糖代谢异常的发生率和高危因素与国外和香港的报道相似,受教育程度作为独立的危险因素在一定程度上反映了中国社会经济方面的变化。     

妊娠期糖尿病发病相关因素的研究进展

妊娠期糖尿病(GDM)是妊娠期的常见病多发病,是指妊娠期间首次发生或发现的不同程度的葡萄糖代谢异常,严重影响着母亲和胎儿的健康。目前GDM的发病机制及危险因素尚未完全明了。现就目前GDM发病的相关因素,如遗传相关因素、系统相关因素和分子水平因素,以及其保护因素的研究情况作一概述。     

妊娠期糖尿病患者发病的危险因素分析

目的:探讨孕妇发生妊娠期糖尿病(GDM)的高危因素。方法:选取2022年1月至2022年10月于杭州市妇产科医院分娩的孕妇150例,其中GDM孕妇75例(GDM组),健康孕妇75例(健康对照组)。收集所有研究对象的临床资料及血常规结果,采用logistic回归分析GDM发病的高危因素。结果:GDM组的孕前体重、分娩前体重、基础BMI、分娩前BMI高于健康对照组,身高低于健康对照组,差异均有统计学意义(P<0.05)。GDM组孕妇的中性粒细胞百分比、红细胞计数、中性粒细胞与淋巴细胞比值(NLR)、C-反应蛋白高于健康对照组,而嗜酸性粒细胞百分比、血小板与中性粒细胞比值(PNR)低于健康对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析发现,嗜酸性粒细胞百分比低是GDM发生的独立危险因素,差异有统计学意义(OR=2.285,P<0.05)。结论:血嗜酸性粒细胞百分比低是GDM发病的高危因素,对于产检发现有指标异常的人群需重点关注。     

妊娠期糖尿病危险因素的研究进展

妊娠期糖尿病（GDM）是妊娠期常见的合并症之一,威胁母婴安全,增加妊娠风险.随着GDM发病率的逐年升高,对其危险因素的研究也越来越受到人们的关注.目前认为,妊娠期胰岛素抵抗（IR）是GDM的主要发病机制.除妊娠妇女的年龄、种族、糖尿病家族史等传统因素外,妊娠妇女体质量指数（BMI）、体内铁含量、遗传基因和感染等因素也可能影响GDM的发病.综述近年来与GDM相关的危险因素的研究进展.     

妊娠期糖尿病--中国人的危险因素和远期影响

早些的研究资料表明,在西方国家多种族社会中,排除不同方法OGTT的影响后,中国人和亚洲人的妊娠期糖尿病（gestational diabetes mellitus, GDM）发病率比其他种族高3～7倍.伦敦的一项研究发现,在对年龄、体重指数（BMI）和产次进行校正后,东南亚女性GDM的相对危险度（RR）为7.6,实际发病率为3.5%.伦敦的另一项研究报道,亚洲女性GDM患病率为5.8%,而白人妇女患病率仅为1.2%.     

妊娠期糖尿病产后糖代谢异常的危险因素

目的通过对妊娠期糖尿病(GDM)患者进行产后随访,回顾性分析影响GDM患者产后糖代谢变化的高危因素。方法收集2009年1月至2011年6月在河北省沧州市中心医院门诊产前检查并分娩的GDM患者236例,产后42d回访者158例,记录其孕前和孕期信息,包括:孕期年龄、身高、孕前体重、有否糖尿病家族史、孕期使用胰岛素情况、孕期并发症及合并症情况、新生儿出生时情况;并按OGTT试验结果分为研究组和对照组,进行高危因素筛查。结果研究组为60例糖耐量异常者,包括39例IGT/IFG患者和21例DM患者;对照组为98例糖耐量正常者,比较两组患者孕前、孕期和妊娠结局情况,结果可见高龄、糖尿病家族史、孕期应用胰岛素、合并子痫前期、早产是产后发生糖代谢异常的高危因素,差异有统计学意义(P<0.05)。结论存在高危因素的GDM患者产后糖代谢异常发生率较高,应针对性地对GDM患者进行产后临床筛查和随访。     

Analysis of risk factors related to gestational diabetes mellitus

ObjectiveWith the rapid rising prevalence, gestational diabetes mellitus (GDM) has become one of the leading causes of maternal and child mortality and morbidity worldwide. The present study aimed to analyze GDM-related risk factors for early intervention.Materials and methodsFrom January to June 2018, a total of 250 pregnant women from Chengdu Second People's Hospital were enrolled in the study. According to the diagnostic criteria for GDM, they were assigned into GDM group (n = 48) and non-GDM group (n = 202). The clinical data and biochemical indicators were compared between GDM group and non-GDM group, and Logistic regression analysis was performed to analyze the risk factors of GDM.ResultsGDM group was significantly higher than non-GDM group in the age, pregnancy times, pre-pregnancy body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) level, history of diabetes mellitus in first-degree relatives, incidence of subclinical hypothyroidism (SCH) and the positive rate of thyroid peroxidase antibody (TPOAb) (P < 0.05), whereas was conspicuously lower than non-GDM group in the education level above junior college (P < 0.05). The results of Logistic regression analysis revealed that the age [odds ratios (OR) = 1.125, 95% confidential interval (CI) = 1.019–1.241, P = 0.020], pre-pregnancy BMI (OR = 1.280, 95%CI = 1.118–1.466, P < 0.001), history of diabetes mellitus in first-degree relatives (OR = 4.938, 95%CI = 1.418–17.196, P = 0.012) and TPOAb (+) (OR = 4.849, 95%CI = 1.742–13.501, P = 0.003) were the risk factors of GDM.ConclusionsAdvanced age, pre-pregnancy BMI overweight, history of diabetes mellitus in first-degree relatives and TPOAb (+) are associated with an increased risk of GDM.     

A risk score for selective screening for gestational diabetes mellitus

Objective

To develop a risk score to predict women who are likely to have an abnormal glucose challenge test (GCT) for gestational diabetes mellitus (GDM) screening.

Study design

A cohort of 1876 pregnant women who underwent a GCT between March 2005 and December 2005 at our institution were studied. A multivariable analysis was performed to determine the clinical features that were significantly associated with an abnormal GCT. These factors were incorporated into the equation which was subsequently transformed to the risk score. The validity of this risk score was then tested in a different cohort of 1900 women who underwent a GCT between October 2006 and July 2007.

Results

Of 1876 women in the derivation cohort, 586 (31.2%) had positive GDM screening. In a multivariable analysis, age, body mass index, family history of diabetes, prior macrosomia, and history of ≥2 spontaneous abortions were significantly associated with an abnormal GCT. These five variables were added into the equation to determine the risk score. At a cutoff score of ≥380, the sensitivity, specificity, positive predictive value, and negative predictive value to predict an abnormal GCT were 86.9%, 45.0%, 41.8%, and 88.3%, respectively. When the equation with the same cutoff score was tested in the validation cohort, a similar diagnostic performance was obtained. By adopting this risk scoring approach to GDM screening, 41.3% of women could avoid GCT.

Conclusion

Our risk score based on clinical data is simple, noninvasive, costless, and reliable to identify women who are likely to have an abnormal GCT.     

Selective or universal diagnostic testing for gestational diabetes mellitus.

OBJECTIVES: To estimate the effect of selective diagnostic testing for gestational diabetes mellitus (GDM): (1) based on evaluation of risk factors; and (2) based on the recommendations of The Fourth Workshop-Conference on GDM. METHODS: A retrospective study was performed of 147 pregnancies complicated by GDM delivered in Kaunas University of Medicine Hospital. The maternal and fetal outcomes and the main risk factors were compared with the same data of a randomly selected 300 women with normal glucose tolerance testing. Logistic regression was used to estimate the odds ratios with 95% confidence interval (CI). RESULTS: The prevalence of all risk factors was significantly higher in the group with GDM, but 29 of these women (23.13%) had no risk factors. Sixteen women (10.9%) with GDM were at low risk and would remain undiagnosed if selective screening would be used. CONCLUSIONS: The recommendations not to test low-risk group women are doubtful and require further examination whereas universal screening of all pregnant women would be justified.     

Risk factors of abnormal carbohydrate metabolism after pregnancy complicated by gestational diabetes mellitus

Objective: In gestational diabetes mellitus (GDM) abnormal glucose metabolism normalizes soon after delivery. However, the history of GDM predisposes to carbohydrate intolerance in the future. The aim of the study was to explore risk factors and to evaluate risk of glucose intolerance and diabetes mellitus in women with a history of GDM. Methods: 155 patients entered this case-control study. Participants fulfilled the inclusion criteria: a history of GDM, perinatal care in the study center. Medical and family history and laboratory findings were analyzed. Oral glucose tolerance test (OGTT) was performed. Results: 18.1% of patients presented impaired fasting glucose during the study, 20% presented impaired glucose tolerance and 23.2% presented diabetes mellitus. Gestational age at diagnosis of GDM, the results of OGTT during pregnancy, serum HbA1c concentration at 2nd and 3rd trimester, serum fructosamine concentration, symptoms of diabetic fetopathy in the neonate, the need for insulin therapy after delivery, maternal age at diagnosis of GDM and maternal body mass index before pregnancy were the significant risk factors of impaired glucose tolerance or diabetes in the future. Conclusion: GDM increases the risk of diabetes mellitus. Several risk factors of impaired carbohydrate metabolism can be distinguished in patients with a history of GDM.     

Risk factors for gestational diabetes mellitus among women screened with the two-step and one-step methods: A before-and-after study

Objective

To compare the risk profiles for gestational diabetes mellitus (GDM) using a one-step and two-step screening method and diagnostic criteria.

妊娠期糖尿病的筛查

目的 对妊娠期糖尿病(GDM)筛查的必要性、适宜时间、临界值及巨大儿的发生进行探讨。方法 回顾性分析1997年10月至1999年9月在北京协和医院行产前检查及分娩的1935例初产妇,孕1～4次。结果 妊娠期糖耐量低减(IGT)及GDM的发生率在孕24周以后无差异。OGT异常者分娩巨大儿较葡萄糖负荷试验(OGT)正常者高。50g糖筛查值在7.8～8.3mmol/L(140～149 mg/dl)的159例孕妇,只有2例诊为IGT,无一例为GDM。结论 在孕24周以后尽可能早地对孕妇进行50g糖筛查是必要的。对于OGT异常者应予以重视,对IGT及GDM者应积极控制血糖。对于高危人群必要时重复筛查。