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伊朗妊娠糖尿病女性产后6至12周持续性高血糖的发生率及相关因素:LAGA队列研究结果

Incidence and Contributing Factors of Persistent Hyperglycemia at 6-12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study.

作者信息

Nouhjah Sedigheh, Shahbazian Hajieh, Shahbazian Nahid, Jahanshahi Alireza, Jahanfar Shayesteh, Cheraghian Bahman

机构信息

Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Obstetrics and Gynecology, Fertility, Infertility and Perinatology Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Diabetes Res. 2017;2017:9786436. doi: 10.1155/2017/9786436. Epub 2017 Apr 12.

Abstract

. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life. . Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6-12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and the American Diabetes Association (ADA) criteria applied for diagnosis of postpartum prediabetes and diabetes. Univariate and multivariate regression analysis were done. . Overall incidence of early postpartum glucose intolerance was 22.2% (95% CI, 16.3-29.0), 17.6% prediabetes (95% CI, 12.3-24.1) and 4.5% diabetes (95% CI, 2.0-8.8%). Independent risk factors for glucose intolerance were FPG ≥ 100 at the time of OGTT (OR 3.86; 95% CI; 1.60-9.32), earlier diagnosis of GDM (OR 0.92; 95% CI; 0.88-0.97), systolic blood pressure (OR 1.02; 95% CI; 1.002-1.04), and insulin or metformin therapy (OR 3.14; 95% CI; 1.20-8.21). . Results determined a relatively high rate of glucose intolerance at 6-12 weeks after GDM pregnancy. Early postpartum screening of type 2 diabetes is needed particularly in women at high risk of type 2 diabetes.

摘要

妊娠期糖尿病病史是日后发生多种代谢紊乱的重要预测指标。妊娠期糖尿病后生活阿瓦士研究(LAGAs)是一项正在进行的基于人群的队列研究。截至2016年2月,176例妊娠期糖尿病女性在伊朗西南部阿瓦士产后6 - 12周接受了75克口服葡萄糖耐量试验(OGTT)。妊娠期糖尿病根据国际糖尿病与妊娠研究组协会(IADPSG)标准以及用于诊断产后糖尿病前期和糖尿病的美国糖尿病协会(ADA)标准进行诊断。进行了单因素和多因素回归分析。产后早期糖耐量异常的总体发生率为22.2%(95%置信区间,16.3 - 29.0),糖尿病前期为17.6%(95%置信区间,12.3 - 24.1),糖尿病为4.5%(95%置信区间,2.0 - 8.8%)。糖耐量异常的独立危险因素为OGTT时空腹血糖≥100(比值比3.86;95%置信区间;1.60 - 9.32)、妊娠期糖尿病的早期诊断(比值比0.92;95%置信区间;0.88 - 0.97)、收缩压(比值比1.02;95%置信区间;1.002 - 1.04)以及胰岛素或二甲双胍治疗(比值比3.14;95%置信区间;1.20 - 8.21)。结果显示,妊娠期糖尿病妊娠后6 - 12周糖耐量异常发生率相对较高。尤其对于2型糖尿病高危女性,需要在产后早期进行2型糖尿病筛查。

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