Li Ling-Jun, Zhang Jun, Shub Alexis, Aris Izzuddin, Tan Kok Hian
Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
BMJ Open Diabetes Res Care. 2020 Feb;8(1). doi: 10.1136/bmjdrc-2019-000903.
Gestational diabetes mellitus (GDM) is a metabolic disorder of pregnancy that is increasingly prevalent among Chinese women. Few studies have examined whether the migration status of Chinese women contributes to the risks of developing GDM during pregnancy.
In this observational, cross-sectional and hospital-based study, we examined the prevalence of GDM and glycemic levels at oral glucose tolerance test (OGTT) among 491 Australian Chinese migrants (n=491) and native Chinese (n=1000). We defined GDM using the International Association of Diabetes and Pregnancy Study Groups guidelines. We collected data on maternal age, body mass index (BMI) and gestational age (GA) at booking and GA at delivery from medical records. We used multiple logistic and linear regression models to calculate the OR of having GDM and mean differences in glycemic levels in Australian Chinese migrants, relative to native Chinese.
Age-at-booking and BMI-at-booking adjusted GDM prevalence was significantly higher in Australian Chinese migrants than native Chinese (19.7% vs 14.6%; p=0.01). After adjusting for age, BMI at booking and GA at booking, fasting glucose levels were significantly lower (β -0.08 mmol/L; 95% CI -0.14 to 0.02), while 2-hour glucose levels were significantly higher (0.22 mmol/L; 0.02 to 0.43) in Australian Chinese immigrants than native Chinese.
Migration status may be a marker for abnormal glucose metabolism during pregnancy among Australian Chinese migrants, possibly due to socio-economic disadvantages and lifestyle changes associated with migration.
妊娠期糖尿病（GDM）是一种妊娠期间的代谢紊乱疾病，在中国女性中越来越普遍。很少有研究探讨中国女性的移民身份是否会增加孕期患GDM的风险。
在这项基于医院的观察性横断面研究中，我们调查了491名澳大利亚华裔移民（n = 491）和1000名中国本土女性的GDM患病率以及口服葡萄糖耐量试验（OGTT）时的血糖水平。我们根据国际糖尿病与妊娠研究组协会的指南定义GDM。我们从医疗记录中收集了产妇年龄、孕早期体重指数（BMI）、孕早期孕周（GA）和分娩时孕周的数据。我们使用多元逻辑回归和线性回归模型计算澳大利亚华裔移民患GDM的比值比（OR）以及与中国本土女性相比血糖水平的平均差异。
调整孕早期年龄和BMI后，澳大利亚华裔移民的GDM患病率显著高于中国本土女性（19.7%对14.6%；p = 0.01）。在调整年龄、孕早期BMI和孕早期孕周后，澳大利亚华裔移民的空腹血糖水平显著较低（β -0.08 mmol/L；95% CI -0.14至0.02），而餐后2小时血糖水平显著较高（0.22 mmol/L；0.02至0.43）。
移民身份可能是澳大利亚华裔移民孕期葡萄糖代谢异常的一个标志，这可能是由于与移民相关的社会经济劣势和生活方式改变所致。
