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目的探讨孕期中胆红素与妊娠期糖尿病(GDM)的相关性。方法以来自在华中科技大学附属武汉市中心医院进行产检和分娩的孕妇为研究对象,对其采用回顾性研究获得基本信息,采用钒酸盐氧化法测定血清中总胆红素(TB)、直接胆红素(DB),采用酶法测定空腹血糖(GLU)的水平,采用免疫比浊法测定c-反应蛋白(CRP)和白蛋白(Alb)。结果 GDM的发病率为7.86%(102/1 297)。TB、DB在GDM组的值要低于非GDM组(5.8±2.2和6.4±2.4,P=0.023;2.4±1.3和2.5±0.9,P=0.036)。进一步采用线性回归分析的方法分析TB、DB与空腹血糖、1h血糖、2h血糖间的线性关系,TB、DB与血糖值呈负相关。Logistic回归分析TB、DB与GDM的相关性,其最高层与最低层相比患GDM的风险降低(RR 0.54;95%CI,0.31~0.95)和(RR 0.61;95%CI,0.38~0.99)。结论妊娠中期高胆红素水平患GDM的风险性降低。
Objective To investigate the relationship between bilirubin and gestational diabetes mellitus (GDM) during pregnancy. Methods The pregnant women who came from Wuhan Central Hospital Affiliated to Huazhong University of Science and Technology for the purpose of childbirth and delivery were studied retrospectively to obtain the basic information. Vanadate oxidation method was used to determine serum total bilirubin (TB), direct gallbladder (DB). The level of fasting blood glucose (GLU) was measured by enzymatic method. CRP and Alb were measured by immunoturbidimetry. Results The incidence of GDM was 7.86% (102/1 297). The values of TB and DB in the GDM group were lower than those in the non-GDM group (5.8 ± 2.2 and 6.4 ± 2.4, P = 0.023; 2.4 ± 1.3 and 2.5 ± 0.9, P = 0.036). Linear regression analysis was used to analyze the linear relationship between TB, DB and fasting blood glucose, 1h blood glucose, 2h blood glucose, TB, DB and blood glucose was negatively correlated. Logistic regression analysis of the association between TB, DB and GDM revealed a lower risk of developing GDM (RR 0.54; 95% CI, 0.31 to 0.95) and (RR 0.61; 95% CI, 0.38 to 0.99) at the highest and lowest levels . Conclusions The risk of developing GDM during the second trimester of pregnancy is reduced.