Analysis of glucose and lipid metabolism and perinatal outcome in different extent gestational diabetes mellitus
10.3760/cma.j.issn.1673-4904.2013.15.011
- VernacularTitle:不同程度妊娠期糖尿病患者糖脂代谢紊乱及围生期结局的对比分析
- Author:
Haiyan ZHU
;
Qingqing WU
;
Jiang HU
- Publication Type:Journal Article
- Keywords:
Diabetes,gestational;
Pregnancy outcome;
IADPSG diagnostic criteria
- From:
Chinese Journal of Postgraduates of Medicine
2013;(15):30-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the glucose and metabolism and perinatal outcome in pregnant women with different extent gestational diabetes mellitus (GDM) of IADPSG diagnostic criteria,and to investigate the necessity to manage mild GDM.Methods Total 368 pregnant women at 24-28 gestational weeks were given 75 g glucose oral glucose tolerance test (OGTT).They were divided into three groups according OGTI result,single abnormal group (GDM1 group,148 cases),combination abnormal group (GDM2 group,120 cases) and normal group (100 cases).The three groups were given determinations of glycosylated hemoglobin,fasting C peptide (FCP),fasting insulin (FINS),total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),apolipoprotein (Apo) A1 and ApoB,calculated homeostasis model of assessment for insulin resistance index (HOMA-IR) and homeostasis beta cell index (HBCI).Results From normal group,GDM1 group to GDM2 group,the fasting plasma glucose,glycosylated hemoglobin,FCP,HOMA-IR,TG were gradually increased [(4.39 ± 0.38),(4.98 ± 0.49),(5.25 ± 0.59) mmol/L; (5.10 ± 0.29)％,(5.27 ± 0.36)％,(5.46 ± 0.46)％ ;(1.37 ±0.67),(1.73 ±0.73),(1.99 ±0.96) μ g/L;1.07 ±0.42,1.26 ±0.54,1.37 ±0.43; (2.77 ±0.67),(3.05 ± 0.78),(3.34 ± 0.92) mmol/L,P ＜ 0.01],while HBCI was gradually decreased (5.93 ± 0.48,5.42 ±0.45,5.29 ± 0.44,P ＜ 0.01).ApoA1 in GDM1 group and GDM2 group were significantly lower than that in normal group [(2.21 ±0.39),(2.15 ±0.35) g/L vs.(2.42 ±0.37) g/L,P ＜0.01],but there was no significant difference between GDM1 group and GDM2 group (P＞ 0.05).ApoB/ApoA1 in GDM2 group was significantly higher than that in normal group and GDM1 group (0.49 ±0.14 vs.0.42 ±0.14 and 0.45 ±0.12,P ＜ 0.01),but there was no significant difference between normal group and GDM 1 group (P ＞ 0.05).There was no significant difference in FINS,TC,HDL-C,LDL-C,ApoB,neonatal weight and the incidence rate of premature delivery among the three groups (P ＞ 0.05).The incidence rates of eclampsism,large for date infant and cesarean section in GDM1 group and GDM2 group were significantly higher than those in normal group [8.1％(12/148) and 14.2％(17/120) vs.2.0％(2/100),14.9％(22/148) and 16.7％(20/120)vs.6.0％(6/100),52.0％(77/148) and 54.2％(65/120) vs.30.0％(30/100),P＜ 0.01].Conclusions Different extent GDM of IADPSG diagnostic criteria has different extent abnormal glucose and lipid metabolism and abnormal perinatal outcome,so it is necessary to diagnose and manage GDM pregnant women even mild GDM.
