Liu Chaoqun, Zhong Chunrong, Zhou Xuezhen, Chen Renjuan, Wu Jiangyue, Wang Weiye, Li Xiating, Ding Huisi, Guo Yanfang, Gao Qin, Hu Xingwen, Xiong Guoping, Yang Xuefeng, Hao Liping, Xiao Mei, Yang Nianhong
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
Departments of Epidemiology and Health Statistic, Wuhan, China.
Endocrine. 2017 Jan;55(1):165-172. doi: 10.1007/s12020-016-1103-6. Epub 2016 Oct 11.
Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.
最近有报道称胆红素浓度与2型糖尿病呈负相关。我们研究了胆红素浓度与妊娠期糖尿病之间的关联。在一项前瞻性队列研究中，招募了2969名妊娠16周前的孕妇，并随访至分娩。检测胆红素值并进行口服葡萄糖耐量试验以筛查妊娠期糖尿病。通过两段式线性回归研究血清胆红素浓度与孕周之间的关系。对1135名在妊娠16 - 18周期间进行血清胆红素检测的参与者进行子样本分析，通过逻辑回归研究血清胆红素水平与妊娠期糖尿病风险之间的关联。8.5%的参与者（2969名中的223名）发生了妊娠期糖尿病。两段式线性回归分析表明，胆红素水平在转折点23周之前随孕周增加而降低，在该点之后，胆红素水平略有升高。在多元逻辑回归分析中，直接胆红素最高三分位数组发生妊娠期糖尿病的相对风险低于最低三分位数组（风险比0.60；95%置信区间，0.35 - 0.89）。结果表明，妊娠中期血清直接胆红素水平较高的女性发生妊娠期糖尿病的风险较低。
