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二甲双胍能否降低多囊卵巢综合征孕妇妊娠期糖尿病的发病率?前瞻性队列研究。

Can metformin reduce the incidence of gestational diabetes mellitus in pregnant women with polycystic ovary syndrome? Prospective cohort study.

机构信息

Egyptian International fertility & IVF Center, Miser International Hospital, Cairo, Egypt.

出版信息

Gynecol Endocrinol. 2011 Oct;27(10):789-93. doi: 10.3109/09513590.2010.540600. Epub 2011 Jan 19.

Abstract

BACKGROUND

Women with polycystic ovary syndrome (PCOS) are at a high risk to develop Gestational Diabetes mellitus (GDM). We hypothesized that metformin due to its metabolic, endocrine, vascular, and anti-inflammatory effects may reduce the incidence of GDM in PCOS women.

PATIENT AND METHOD

We carried out a prospective cohort study to determine the beneficial effects of metformin on PCOS patients during pregnancy. Three-hundred and sixty non-diabetic PCOS patients were included who were conceived on metformin by different treatment modalities. Two-hundred pregnant women continued on metformin at a dose of 1000-2000 mg daily throughout pregnancy (study group) and 160 women discontinued metformin use at the time of conception (control group).

RESULTS

There is a statistically significant reduction in the incidence of GDM in favor of metformin group (OR: 0.17, 95% CI: 0.07-0.37). There is a statistically significant reduction in the incidence of pre-eclampsia in favor of metformin group (OR: 0.35, 95% CI: 0.13-0.94).

CONCLUSION

Metformin is a promising medication for the prevention or reduction of the incidence of GDM and pre-eclampsia in PCOS women.

摘要

背景

多囊卵巢综合征(PCOS)女性发生妊娠糖尿病(GDM)的风险较高。我们假设二甲双胍由于其代谢、内分泌、血管和抗炎作用,可能会降低 PCOS 女性 GDM 的发生率。

患者和方法

我们进行了一项前瞻性队列研究,以确定二甲双胍对妊娠期间 PCOS 患者的有益作用。共纳入 360 名非糖尿病 PCOS 患者,她们通过不同的治疗方式接受了二甲双胍治疗而受孕。200 名孕妇在整个孕期继续使用二甲双胍(剂量为 1000-2000mg/天)(研究组),而 160 名孕妇在受孕时停止使用二甲双胍(对照组)。

结果

二甲双胍组 GDM 的发生率明显降低(OR:0.17,95%CI:0.07-0.37)。二甲双胍组子痫前期的发生率明显降低(OR:0.35,95%CI:0.13-0.94)。

结论

二甲双胍是预防或降低 PCOS 女性 GDM 和子痫前期发生率的有前途的药物。

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