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挪威多囊卵巢综合征妇女中妊娠糖尿病的患病率及危险因素:根据世界卫生组织和改良的 IADPSG 标准。

Gestational diabetes mellitus among Norwegian women with polycystic ovary syndrome: prevalence and risk factors according to the WHO and the modified IADPSG criteria.

机构信息

Department of Medicine, Drammen Hospital, Vestre Viken, Norway.

出版信息

Eur J Endocrinol. 2013 Jun 7;169(1):65-72. doi: 10.1530/EJE-12-1107. Print 2013 Jul.

DOI:10.1530/EJE-12-1107
PMID:23636445
Abstract

OBJECTIVE

The consequences of the recently proposed International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria for gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS) are not known. We compared the prevalence rates and risk factors for GDM in PCOS women according to both the WHO and the modified IADPSG criteria.

DESIGN

Post hoc analyses from a randomized, multicenter study were used.

METHODS

Fasting and 2-h plasma glucose levels were measured using a 75 g oral glucose tolerance test. GDM was diagnosed according to both the WHO and the modified IADPSG criteria.

RESULTS

The prevalence rates of GDM according to the WHO and the modified IADPSG criteria were 9.2 and 15.0% at week 12, 18.7 and 18.7% at week 19, and 25.6 and 24.2% at week 32. Shorter stature and increased insulin levels were correlated with WHO-GDM, but not with modified IADPSG-GDM at weeks 12 and 19. Less weight gain in pregnancy predicted GDM according to both sets of criteria. GDM diagnosis was correlated with less maternal weight loss the first year post-partum.

CONCLUSIONS

No difference was found in the prevalence of GDM between the two sets of criteria used. Less weight gain in pregnancy was associated with GDM, independent of the diagnostic criteria used. Reduced weight loss the first year post-partum in women with GDM raises the question of whether GDM diagnosis per se or the fact that these women lose less weight after pregnancy predicts later diabetes mellitus.

摘要

目的

最近提出的国际妊娠糖尿病研究组(IADPSG)标准对多囊卵巢综合征(PCOS)妇女的妊娠糖尿病(GDM)的后果尚不清楚。我们比较了根据世界卫生组织(WHO)和改良 IADPSG 标准,PCOS 妇女中 GDM 的患病率和危险因素。

设计

使用随机、多中心研究的事后分析。

方法

使用 75g 口服葡萄糖耐量试验测量空腹和 2 小时血浆葡萄糖水平。根据 WHO 和改良 IADPSG 标准诊断 GDM。

结果

根据 WHO 和改良 IADPSG 标准,GDM 的患病率在第 12 周时分别为 9.2%和 15.0%,第 19 周时分别为 18.7%和 18.7%,第 32 周时分别为 25.6%和 24.2%。身材矮小和胰岛素水平升高与 WHO-GDM 相关,但与第 12 周和第 19 周的改良 IADPSG-GDM 无关。怀孕期间体重增加较少可预测两种标准的 GDM。GDM 诊断与产后第一年体重减轻相关。

结论

两种标准的 GDM 患病率无差异。怀孕期间体重增加较少与 GDM 相关,与使用的诊断标准无关。GDM 妇女产后第一年体重减轻较少,这引发了一个问题,即 GDM 的诊断本身还是这些妇女在怀孕后体重减轻较少,是否预示着以后会发生糖尿病。

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