孕期接受长期皮质类固醇治疗患者的妊娠期糖尿病
Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy.
作者信息
Yildirim Yusuf, Tinar Sivekar, Oner Recai Soner, Kaya Baris, Toz Emrah
机构信息
Aegean Obstetrics and Gynecology Training and Research Hospital, Department of Obstetrics and Gynecology, Yenisehir, Izmir, Turkey.
出版信息
J Perinat Med. 2006;34(4):280-4. doi: 10.1515/JPM.2006.053.
AIM
Little data exist on the impact of chronic low dose corticosteroid therapy during pregnancy on gestational diabetes mellitus (GDM).
METHOD
We compared 25 pregnant women receiving long-term (>4 weeks) corticosteroid for newly diagnosed idiopathic thrombocytopenic purpura (ITP) (study group) and 108 normal pregnant women (control group) in this case-control study. Main outcome measures were 1-h, 50-g and 3-h, 100-g glucose tolerance tests (GTTs). Women in both groups were also screened with 75-g GTT 6 weeks after delivery.
RESULTS
The mean duration of corticosteroid therapy was 9.8+/-4.9 (range 6-25) weeks. Compared with controls, study group patients had a greater prevalence of diagnosed GDM (24.0 vs. 2.8%, P=0.01). Of these patients, 83.3% were diagnosed with GDM at 16 weeks gestation. An impaired 75-g GTT was also more frequent in the study group (P=0.01).
CONCLUSION
Our findings suggest that long-term corticosteroid therapy may be associated with the development of diabetes in pregnant women and early GTT should be performed in pregnant women on corticosteroid therapy.
目的
关于孕期慢性低剂量皮质类固醇激素治疗对妊娠期糖尿病（GDM）影响的数据较少。
方法
在这项病例对照研究中，我们比较了25名因新诊断的特发性血小板减少性紫癜（ITP）接受长期（>4周）皮质类固醇激素治疗的孕妇（研究组）和108名正常孕妇（对照组）。主要观察指标为1小时、50克和3小时、100克葡萄糖耐量试验（GTT）。两组女性在分娩后6周也进行了75克GTT筛查。
结果
皮质类固醇激素治疗的平均持续时间为9.8±4.9（范围6 - 25）周。与对照组相比，研究组患者确诊GDM的患病率更高（24.0%对2.8%，P = 0.01）。在这些患者中，83.3%在妊娠16周时被诊断为GDM。研究组中75克GTT受损的情况也更常见（P = 0.01）。
结论
我们的研究结果表明，长期皮质类固醇激素治疗可能与孕妇患糖尿病有关，接受皮质类固醇激素治疗的孕妇应尽早进行GTT检查。
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