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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

22卷

期数:

2016年03期

页码:

226-229

栏目:

临床医学

出版日期:

2016-05-20

文章信息/Info

Title:

Correlation between weight gain and visfatin level and neonatal body composition in gestational diabetes mellitus patients

文章编号:

1006-8147（2016）03-0226-04

作者:

孙 虹; 华绍芳; 苏莉军

(天津医科大学第二医院产科,天津,300211)

Author(s):

SUN Hong;  HUA Shao-fang; SU Li-jun

(Department of Obstetrics, The Second Hospital ，Tianjin Medical University, Tianjin 300211, China)

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关键词:

妊娠期糖尿病; 体质量增长; 内脂素; 新生儿; 体成分

Keywords:

Gestational diabetes mellitus' target="_blank" rel="external">" align="left">Gestational diabetes mellitus;  weight gain;  visfatin;  newborn;  body composition

分类号:

R714

DOI:

-

文献标志码:

A

摘要:

目的：探讨妊娠期糖尿病（GDM）患者妊娠不同时期体质量增长与母体内脂素水平及新生儿体成分的相关性。方法：2013年7月-2015年7月分娩的妊娠足月孕妇，以年龄匹配原则，选取GDM孕妇及糖耐量正常（NGT）孕妇各130例，分为4组：NGT孕妇分娩适于胎龄儿（AGA）组 (NGT+AGA组,n =97 )、NGT孕妇分娩大于胎龄儿（LGA）组(NGT+LGA组,n =33)、GDM+AGA（n =69)和GDM+LGA（n =61)。收集临床资料，回顾性分析孕26周前、26～32周、32周至分娩3个阶段孕妇体质量增长情况；双抗体夹心酶标免疫(ELISA)分析法检测孕妇血清内脂素水平；新生儿出生后24～48 h内进行人体成分测量。分析不同组别孕妇妊娠不同时期体质量增长情况；比较组间内脂素水平及新生儿出生体质量（BW）、体脂百分含量（F %）的差异。结果:GDM患者孕前体质指数（BMI）明显高于NGT孕妇 (F = 13．247， P <0．001）；4组孕期增重存在显著性差异（F =5.501，P <0.001）， GDM+LGA组明显高于NGT+AGA组（P <0.001）。 GDM组孕妇妊娠孕26周之前体质量增速明显高于NGT组；GDM+LGA组孕妇妊娠32周至分娩前的体质量增速也显著增加。4组内脂素水平分别为(90．69±18．94)、(116.28±46．96)、(112.88±44.66)和(208.15±81.89)μg/L（F =72.602，P <0.001），GDM+LGA组显著高于其余3组（均P <0.001）。4组新生儿F %存在显著性差异，任意2组间的差异均有统计学意义（均P <0.05）。孕妇内脂素水平与新生儿出生体质量及体脂含量均呈显著正相关（r =0.539,0.629，均P <0.001），孕前BMI、孕26周前体质量增速、32周至分娩前的体质量增速是其重要相关因素。结论:孕前BMI以及孕26周前体质量增速是GDM的相关危险因素；32周至分娩前体质量增速则与新生儿出生体质量及体脂含量增加密切相关。孕妇内脂素水平可能是联系孕期体质量增长与新生儿体成分的中介因子。

Abstract:

Objective ：To study the weight gain during pregnancy in gestational diabetes mellitus(GDM) patients and the relationship between weight gain and maternal visfatin levels and the neonatal body composition. Methods： A retrospective study was carried out．Women who had full-term deliveries between July 2013 to July 2015 were enrolled． According to maternal age, they were divided into four groups：appropriate for gestational age(AGA) fetuses of mothers with normal glucose tolerance(NGT) （NGT+AGA group, n =97), large for gestational age (LGA) infants of mothers with NGT(NGT+LGA group, n =33),GDM+AGA group（n =69), GDM+LGA group（n =61).Clinical and perinatal information were collected. The maternal weight gain was recorded at early pregnancy- 26 weeks,26⁺¹-32 weeks,32⁺¹weeks before delivery．ELISA method was applied to detect serum visfatin levels in pregnant women. Within 24 - 48 hour after birth, the neonatal body composition was measured. Variance between different groups and the correlation between maternal weight gain and visfatin levels and the percent of body fat in newborn were analyzed . Results：The basic body mass index (BMI) in GDM patients was significantly higher than NGT pregnant women (F = 13.247,P <0.001). There were significant differences in total weight gain among the four groups（F =5.501，P <0.001）, and we found GDM+LGA group was significantly higher than NGT+AGA group（P <0.001）.Weight gain speed before 26 weeks among GDM +AGA, GDM+LGA groups were higher than those in NGT groups (P <0.05). After 32 weeks, weight gain speed in GDM+LGA group was highest. Maternal visfatin levels in four groups were (90.69±18.94),(116.28±46.96),(112.88±44.66) and(208.15±81.89)μg/L（F =72.602，P <0.001）. The value in GDM+LGA group was significantly higher than the other three groups (all P <0.001). The neonatal percentages of body fat (F %) in four groups were different significantly, and difference was found between any two groups (P <0.05). Serum visfatin level in pregnant women was positively related with newborn birth weight and F% (r =0.539,0.629，all P <0.001). Basic BMI, weight gain 26 weeks before and 32 weeks after were important related factors. Conclusion：Basic BMI and weight gain before 26 weeks may be the risk factors for GDM. Maternal weight gain from 32 weeks to delivery is the could be correlated neonatal birth weight and body composition, and visfatin level may be the intermediary factor.

参考文献/References:

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备注/Memo

备注/Memo:

基金项目 天津市卫生局科技基金资助项目(2012KZ084)
作者简介 孙虹（1982-），女，硕士在读，研究方向：围产医学；通信作者：华绍芳，E-mail：hsf1974@126.com。

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更新日期/Last Update: 2016-05-25