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目的探讨妊娠期糖尿病(GDM)患者骨密度情况及影响因素。方法选择2007年12月至2012年5月在孝感市中心医院产检和住院的孕妇,分为2组。正常孕妇160例(对照组),年龄23~33岁,平均年龄28.91岁,平均孕周27.12周。临床确诊为GDM的患者156例(GDM组),年龄27~35岁,平均年龄30.72岁,平均孕周27.64周。应用超声骨密度测定仪测定孕妇右侧跟骨骨密度,检测空腹血糖(FPG)、糖化血红蛋白(Hb A1C),并进行统计学分析。结果 GDM组孕妇骨密度检测结果中声幅衰减(BUA)、超声速度(SOS)、硬度指数(SI)均明显低于对照组(P<0.05);GDM组骨量减少、骨质疏松比例分别为15.38%、5.13%,明显高于对照组(P<0.05);Pearson相关分析显示,SI与年龄、孕周、体质量指数、FPG、Hb A1C有显著相关性(P<0.05)。结论 GDM患者骨量减少及骨质疏松发生率较正常孕妇明显升高;且跟骨超声骨密度、SI与年龄、孕周、体质量指数、FPG、Hb A1C相关。
Objective To investigate the bone mineral density (BMD) and its influencing factors in patients with gestational diabetes mellitus (GDM). Methods Pregnant women who were examined and hospitalized in Xiaogan Central Hospital from December 2007 to May 2012 were divided into two groups. 160 normal pregnant women (control group), aged 23 to 33 years, mean age 28.91 years, an average of 27.12 weeks gestational age. There were 156 patients (GDM group) clinically diagnosed as GDM, with a mean age of 30.72 years and an average gestational age of 27.64 weeks. The right calcaneal bone mineral density (BMD) of pregnant women was measured by ultrasonic bone mineral density meter. Fasting blood glucose (FPG) and HbA1c were detected and analyzed statistically. Results In the GDM group, the amplitude of BUA, SOS and SI of the pregnant women were significantly lower than those of the control group (P <0.05). The bone mass and the proportion of osteoporosis in the GDM group were significantly lower than those in the control group (P <0.05). Pearson correlation analysis showed that there was a significant correlation between SI and age, gestational age, body mass index, FPG and Hb A1C (P <0.05). Conclusion The incidence of osteopenia and osteoporosis in GDM patients were significantly higher than those in normal pregnant women. The bone mineral density, SI, age, gestational age, body mass index, FPG and Hb A1C were related to calcaneus.