糖代谢异常孕妇脐血血脂与新生儿体质指数的关系

目的 探讨在血糖控制良好的糖代谢异常的孕妇中,脐血血脂与新生儿体质指数的关系. 方法 收集2006年11月至2007年2月住院分娩的孕妇150例,其中糖代谢异常(包括妊娠期糖尿病和妊娠期糖代谢异常)且血糖控制良好的孕妇73例,糖耐量正常的孕妇77例,其新生儿分为大于胎龄儿(large for gestational age,LGA)25例和适于胎龄儿(appropriate forgestational age,AGA)125例两组.分析两组新生儿的体质指数、脐血血脂[包括高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)、甘油三酯(triglyceride,TG)、总胆固醇(total cholestrol,TC)]等指标,并对上述指标进行比较和相关、回归分析. 结果 脐血HDL、LDL、TC水平在两组间无差异,脐血TG水平LGA组高于AGA组[(0.23±0.16)mmol/L和(0.14±0.08)mmol/L,P＜0.05].在糖代谢异常孕妇的新生儿中,LGA儿的出生体重与脐血TG水平正相关(r=0.625,P＜0.05),与脐血HDL、LDL、TC不相关.在糖耐量正常孕妇的新生儿中,LGA儿的体质指数与脐血血脂指标均不相关.分娩LGA儿的危险因素为:孕期增重≥18 kg,脐血TG＞0.11 mmol/L. 结论 血脂代谢与新生儿体质指数密切相关;脐血TG可能参与了精代谢异常孕妇分娩LGA的发病机制;脐血TG＞0.11 mmol/L时更容易发生LGA.

Relationship between cord blood lipid profiles and neonatal body index in mothers with abnormal glucose metabolosm during pregnancy

Objective To explore the relationship of lipid metabolism with neonatal body index in mothers with abnormal glucose metabolism during pregnancy and how lipid metabolism inflenees fetal growth. Methods This study recruited 150 mothers and their babies admitted in our hospital from November 2006 to February 2007 including 73 eases of abnormal glucose metabolism with good glycemic control and 77 with normal glucose tolerance. The babies were divided into two groups:LGA (n=25) and AGA (n=125). Clinical data and serum lipid profiles(HDL,LDL,TG,TC)in cord blood were obtained and analyzed Results No significant difference in cord blood levels of HDL, LDL, TC were found between LGA and AGA group, however, with mild elevated TG level in LGA group [(0. 23±0. 16) mmol/L vs (0. 14±0.08)mmol/L,P<0. 05]. In newborns of mothers with abnormal glucose metabolism, the birth weight of LGA infanta was positively correlated with cord blood TG level(r= 0. 625, P<0. 05), but not with the HDL, LDL or TC level. In newborns of mothers with normal glucose tolerance, the body index of LGA infants was not correlated with cord blood lipid profiles. Risk factors of delivering LGA infants were:weight gain during pregnancy≥18 kg, cord blood TG>0. 11 mmol/L. Conclusions LGA infants have a higher level of cord blood TG than AGA which implies that cord blood TG may play a role in fetal overgrowth in mothers with abnormal glucose metabolism. LGAs are more likely to occur when cord blood TG＞0. 11 mmol/L.