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目的了解妊娠糖尿病/妊娠糖耐量低减(GDM/GIGT)患者妊娠晚期血脂变化,以及其与孕期体重变化的关系。对象与方法100g葡萄糖口服糖耐量试验(OGTT)筛查,按照美国糖尿病学会(ADA)标准诊断为GDM或妊娠糖耐量低减(GIGT)的第三孕程初期的初产妇女(即孕24周~30周)。记录孕前体重、测量身高、分娩前体重,于孕29周±7日采空腹静脉血测定血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白a(Lipoprotein a,Lpa)。结果GDM/GIGT孕晚期HDL-c、ApoA1、TG显著升高,TC、LDL-c、ApoB轻度升高。多数GDM/GIGT患者孕前体质指数(BMI)处于正常范围,而孕期体重增长过高。不同孕前BMI水平或孕期体重增长水平的患者各血脂指标没有显著差异,且孕前BMI或孕期体重增长与各血脂指标没有显著相关。LDL-c升高组与正常组孕前BMI、孕期体重增长没有差异。结论本研究初步证实GDM/GIGT患者存在与正常妊娠相似的孕晚期血脂升高现象,这种变化与孕前的BMI或孕程中的体重变化没有显著相关。
Objective To understand the changes of serum lipids in gestational diabetes mellitus / gestational diabetes mellitus with impaired glucose tolerance (GDM / GIGT) and its relationship with body weight during pregnancy. Subjects and Methods 100 g Glucose Oral Glucose Tolerance Test (OGTT) screening, primiparous women in the third trimester of pregnancy diagnosed with GDM or GIGT according to the American Diabetes Association criteria (ie 24 weeks gestation ~ 30 weeks). The body weight before pregnancy, height, and body weight before delivery were recorded. The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c) Lipoprotein cholesterol (LDL-c), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), lipoprotein a (Lipoprotein a, Lpa). Results The levels of HDL-c, ApoA1 and TG in the third trimester of GDM / GIGT were significantly increased, and the levels of TC, LDL-c and ApoB were slightly increased. Most GDM / GIGT patients with pre-pregnancy body mass index (BMI) in the normal range, while the weight gain during pregnancy is too high. There was no significant difference in serum lipids between different pre-pregnancy BMI or pregnancy weight gain, and there was no significant correlation between pre-pregnancy BMI or pregnancy weight gain and serum lipids. LDL-c elevated group and normal group BMI before pregnancy, pregnancy weight gain no difference. Conclusions Our study initially confirmed the presence of hyperlipidemia in the third trimester of pregnancy in GDM / GIGT patients, similar to that of normal pregnancy. This change was not significantly associated with pre-pregnancy BMI or weight gain during pregnancy.