Diabetologia:基于胰岛素抵抗的妊娠期糖尿病亚型的特征和妊娠结局

2019-12-24 MedSci MedSci原创

本研究旨在基于胰岛素抵抗确定妊娠期糖尿病(GDM)不同亚型的特征和妊娠结局。

本研究旨在基于胰岛素抵抗确定妊娠期糖尿病(GDM)不同亚型的特征和妊娠结局。

GDM亚型是在1813年的一项多中心前瞻性队列研究中定义的,根据胰岛素抵抗进行分层,根据Matsuda指数低于第50百分位的葡萄糖耐受正常(NGT)的妇女,在妊娠24-28周期间进行75 g OGTT。根据2013年世卫组织标准,所有参与者中12.4% (n = 228)诊断GDM

与具有NGT的女性(占总队列的1113 [61.4])和对胰岛素敏感的GDM的女性(占39 [17.1]GDM女性)相比而言,具有GDM和高胰岛素抵抗的女性(189 [82.9]GDM女性)相比)妊娠早期的BMI,收缩压,空腹血糖(FPG),空腹总胆固醇LDL-胆固醇和三酰甘油水平显著升高。与NGT的女性相比,胰岛素敏感的GDM女性的BMI显著降低,但妊娠早期的BPFPG和空腹血脂水平相似。与具有NGT的女性相比,具有GDM和高胰岛素抵抗的女性具有较高的早产率(8.5vs 4.7%,p = 0.030),引产(42.7vs 28.1%,p <0.001),剖腹产(总剖宫产)剖宫产:28.7vs 19.4%,p = 0.004;急诊剖腹产:16.0vs 9.7%,p = 0.010),新生儿低血糖症(15.4vs 3.5%,p <0.001)和新生儿重症监护室入院(16.0vs 8.9%,p = 0.003)。在使用不同模型进行人口统计学,BMIFPGHbA1c,早期妊娠,早产(OR 2.41 [95CI 1.085.38])和新生儿低血糖症(OR 4.86 [OR]的血脂水平和妊娠体重增加)调整的多变量logistic回归分析中与NGT妇女相比,GDM和高胰岛素抵抗女性的95CI 2.0411.53]仍然显著更高。 GDM的胰岛素敏感性妇女的妊娠结局与NGT的妇女相似。妊娠期胰岛素治疗的需要和产后早期葡萄糖不耐症的发生率在GDM亚型之间没有显著差异。

研究结果表明,高胰岛素抵抗的GDM表现出更不良的代谢状况和更高的不良妊娠结局风险。

原始出处:

Katrien BenhalimaEmail authorPaul Van CrombruggeCharacteristics and pregnancy outcomes across gestational diabetes mellitus subtypes based on insulin resistance

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    2020-09-30 baoya
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    2019-12-24 misszhang

    谢谢MedSci提供最新的资讯

    0

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