【摘要】 目的:调查中国昆明地区妊娠期糖尿病(GDM)孕妇的人口统计学和社会危险因素。方法:对2004年1月至2009年12月期间在昆明一所三甲教学医院和两家民营医院接受75g口服葡萄糖耐量试验(OGTT)的8538例单胎孕妇进行前瞻性研究。结果:研究期间该地区GDM的总体发生率为12.5%(IGT 11.7%,GDM 0.8%);孕妇受教育程度最高组(硕士及以上)GDM的发生率最高(16.4%),显著高于大学大专组(16.4%vs12.8%,P=0.036)、高中中专组(16.4%vs 12.4%,P=0.028)和初中及以下组(16.4%vs 10.9%,P=0.002)。多元Logistic回归显示孕妇年龄(OR=1.61,95%CI 1.42～1.83,P=0.000),OGTT时体重指数(OR=1.15,95%CI 1.11～1.20,P=0.000),一级亲属糖尿病(DM)家族史(OR=1.96,95%CI 1.45～2.64,P=0.000),受教育程度(OR=1.16,95%CI 1.02～1.35,P=0.047)是发生GDM的独立危险因素。结论:昆明地区研究期间妊娠期糖代谢异常的发生率和高危因素与国外和香港的报道相似,受教育程度作为独立的危险因素在一定程度上反映了中国社会经济方面的变化。更多还原

【Abstract】 Objective:To investigate maternal social and demographic risk factors for gestational diabetes mellitus(GDM)in Kunming Chinese pregnant women.Methods:In a prospective study,75g oral glucose tolerance test(OGTT)was performed in 8538 singleton pregnant women living in Kunming who received antenatal care in a teaching hospital or one of the two private hospitals from Jan.2004 to Dec.2009.GDM was diagnosed according to the WHO criteria.A computerized database was used in a multivariate logistic regression to identify independently significant risk factors related to GDM.Results:The total incidence of GDM in the study period was 12.5%(IGT 11.7%,GDM 0.8%).Compared with the incidence of GDM in the highest educational level(M.phil degree or higher,16.4%),university educational level,high school and primary educational levels had significantly lower incidences than M.phil(12.8% vs 16.4%,P=0.036,12.4% vs 16.4%,P=0.028 and 10.9% vs 16.4%,P=0.002 respectively).Multivariate logistic regression analysis showed that maternal age(OR=1.61,95%CI 1.42~1.83,P=0.000),BMI at OGTT(OR=1.15,95%CI 1.11~1.20,P=0.000),family history of diabetes in first degree relatives(OR=1.96,95%CI 1.45~2.64,P=0.000)and educational level(OR=1.16,95%CI 1.02~1.35,P=0.047)were independent risk factors for GDM.Conclusions:The incidence of GDM and the risk factors of GDM in our population are similar with those in overseas and Hong Kong Chinese identified by the same diagnostic criteria.The fact that those with higher educational levels are more likely to be affected by GDM reflects social and economic changes in China.更多还原