妊娠期糖尿病患者脂质代谢水平及对子代的影响

目的研究妊娠期糖尿病(GDM)患者脂质代谢水平及对新生儿出生体质量和肾功能的影响。方法收集2013年2月至2014年4月湖北医药学院附属东风医院收治的GDM孕妇39例,正常妊娠期孕妇47例,测定两组孕妇血脂(总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)水平和两组新生儿血清胱抑素C、β2微球蛋白水平,并记录两组新生儿出生体质量等。结果 GDM组孕妇血清三酰甘油、总胆固醇水平显著高于正常妊娠组(3.1±1.4)mmol/L vs(2.0±0.9)mmol/L、(5.9±2.1)mmol/L vs(4.6±1.7)mmol/L,P<0.05],且新生儿体质量及血清胱抑素C、β2微球蛋白较正常妊娠组显著升高(P<0.05)。GDM组巨大儿出生率升高,新生儿发生早期肾功能损害。Pearson相关性分析结果显示三酰甘油、总胆固醇水平与新生儿出生体质量、血清胱抑素C、β2微球蛋白的水平呈正相关性(P<0.05)。结论与正常妊娠妇女比较,GDM患者脂质代谢紊乱严重,并对新生儿出生体质量和肾脏功能产生影响。对妊娠期孕妇进行饮食指导和血脂监测有重要意义。

Level of Lipid Metabolism on Patients with Gestafional Diabetes Mellitus and Its Influence on the Newborn

Objecfive To study the effects of lipid metabolism in patients with gestational diabetes mellitus（GDM） on weight and renal function of the newborn. Methods A total of 47 normal pregnant women and 39 women with GDM from Dongfeng Hospital Mfiliated to Hubei Medical College from Feb. 2013 to Apr. 2014 were included in this study. Blood lipid levels total cholestero （CTC） ,triacylglycerol （CTG）, high density lipoprotein cholesterol （CHDL-C） ,low density cipoprotein cholesterol （LDL-C）and serum eystatine （CYS-C）, β2-microglo-bulin （β2-MG） concentration of the newborns were measured. And birth weight of the two groups was recorded. Results The level of serum TC,TG in GDM group were significantly higher than that of normal pregnancy group （ 3.1±1.4 ） mmol/L vs （2.0±0.9 ）mmol/L, （5.9±2.1 ） mmol/L vs （4.6 ±1.7 ） mmol/L,P 〈 0.05 ], the weight and Cys-C, β2-MG of newborn in GDM group increased significantly（ P 〈 0.05 ）. Macrosomia birth rate of GDM group was increased, and early renal damage of the newborn was detected. Pearson correlation analysis showed that TG, TC levels had positive correlation with levels of birth weight, serum Cys-C, β2-MG（ P 〈 0, 05 ）. Conclusion Compared with normal pregnant women, lipid metabolic disorder of GDM patients is more serious, impacting the weight and renal function of he newborn. Giving the dietary guidance to pregnant women and monitoring the blood lipid during pregnancy are important.