Laughon S Katherine, Catov Janet, Provins Traci, Roberts James M, Gandley Robin E
Department of Obstetrics, Gynecology and Reproductive Services, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Am J Obstet Gynecol. 2009 Oct;201(4):402.e1-5. doi: 10.1016/j.ajog.2009.06.065.
We sought to demonstrate that elevated first-trimester uric acid is associated with development of gestational diabetes mellitus (GDM).
Uric acid was measured in 1570 plasma samples collected at mean gestational age of 8.9 +/- 2.5 weeks. The primary outcome was GDM, diagnosed by 3-hour glucose tolerance test using Carpenter and Coustan criteria or by a 1-hour value of > or =200 mg/dL. Logistic regression was performed, adjusting for relevant covariates.
Almost half (46.6%) of the women with GDM had first-trimester uric acid concentrations in the highest quartile (>3.57-8.30 mg/dL). Women with uric acid in the highest quartile had a 3.25-fold increased risk (95% confidence interval, 1.35-7.83) of developing GDM after adjustment for body mass index and age. This effect was concentration dependent as risk increased with increasing uric acid quartiles (P = .003).
First-trimester hyperuricemia is associated with an increased risk of developing GDM, independent of body mass index.
我们试图证明孕早期尿酸升高与妊娠期糖尿病（GDM）的发生有关。
在平均孕龄8.9±2.5周时采集的1570份血浆样本中测量尿酸。主要结局为GDM，通过采用Carpenter和Coustan标准的3小时葡萄糖耐量试验或1小时血糖值≥200mg/dL进行诊断。进行逻辑回归分析，并对相关协变量进行校正。
几乎一半（46.6%）的GDM女性孕早期尿酸浓度处于最高四分位数（>3.57 - 8.30mg/dL）。在对体重指数和年龄进行校正后，尿酸处于最高四分位数的女性发生GDM的风险增加了3.25倍（95%置信区间，1.35 - 7.83）。这种效应呈浓度依赖性，随着尿酸四分位数的增加风险升高（P = 0.003）。
孕早期高尿酸血症与发生GDM的风险增加有关，独立于体重指数。
