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身材矮小的女性是否有患妊娠糖尿病的风险?

Are short women at risk for gestational diabetes mellitus?

机构信息

Outpatient Clinic for Diabetic Pregnant Women, 71-455 Szczecin, Poland.

出版信息

Eur J Endocrinol. 2010 Mar;162(3):491-7. doi: 10.1530/EJE-09-0992. Epub 2009 Dec 1.

Abstract

OBJECTIVE

The aim of the study was to assess the influence of height variations on the risk of gestational diabetes mellitus (GDM).

RESEARCH DESIGN AND METHODS

We analyzed the medical records of 1830 Caucasian women with GDM and 1011 healthy pregnant women. The following data were collected: age, prior macrosomia, prior GDM, parity, history of type 2 diabetes in first-degree relatives, weight before pregnancy, weight gain during pregnancy, glucose level at the first obstetric visit, results of the glucose challenge test and oral glucose tolerance test (OGTT), HbA1c, and method for treatment of GDM.

RESULTS

Women with GDM were significantly shorter than the healthy controls (165.7+/-5.6 vs 163.8+/-6.6 cm; P<0.001). The differences in height were not significant between GDM women who required insulin therapy and those treated with diet alone (P=0.12). All the studied variables, including height, were independently associated with GDM. Even after adjustment for confounding variables, height was still associated with GDM (odds ratio 0.958, 95% confidence interval: 0.94-0.97; P<0.00001). In women with GDM diagnosed by 75-g OGTT, we found a significant inverse association of height adjusted for age and pregravid weight with 2-h glucose level (beta=-0.12; P<0.0001).

CONCLUSIONS

Caucasian women with GDM are shorter than pregnant women without GDM regardless of the diagnostic criteria used or the severity of glucose intolerance. Although height is an independent predictor for GDM, its predictive value for identifying women at risk is relatively low and should not be considered in selective screening for this disease.

摘要

目的

本研究旨在评估身高变化对妊娠期糖尿病(GDM)风险的影响。

研究设计与方法

我们分析了 1830 例白人 GDM 患者和 1011 例健康孕妇的病历。收集的数据包括:年龄、既往巨大儿、既往 GDM、产次、一级亲属 2 型糖尿病史、孕前体重、孕期体重增加、首次产检时的血糖水平、葡萄糖筛查试验和口服葡萄糖耐量试验(OGTT)结果、HbA1c 以及 GDM 的治疗方法。

结果

GDM 患者明显比健康对照组矮(165.7+/-5.6 与 163.8+/-6.6 cm;P<0.001)。需要胰岛素治疗和单纯饮食治疗的 GDM 患者之间,身高差异无统计学意义(P=0.12)。所有研究变量,包括身高,均与 GDM 独立相关。即使在调整混杂因素后,身高仍与 GDM 相关(比值比 0.958,95%置信区间:0.94-0.97;P<0.00001)。在 75-g OGTT 诊断的 GDM 患者中,我们发现身高(经年龄和孕前体重校正)与 2 小时血糖水平呈显著负相关(β=-0.12;P<0.0001)。

结论

无论使用何种诊断标准或血糖不耐受严重程度,白人 GDM 患者均比无 GDM 的孕妇矮。尽管身高是 GDM 的独立预测因素,但预测 GDM 风险的价值相对较低,不应在该病的选择性筛查中考虑。

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