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妊娠早期白细胞计数与妊娠期葡萄糖不耐受的关系。

Association of leukocyte counts in the first trimester with glucose intolerance during pregnancy.

机构信息

Tianjin Women and Children's Health Center, Tianjin, China.

Tianjin Medical University, Tianjin, China.

出版信息

J Diabetes Investig. 2022 Jan;13(1):191-200. doi: 10.1111/jdi.13633. Epub 2021 Aug 8.

Abstract

AIMS/INTRODUCTION: We investigated the association between leukocyte counts and glucose challenge test (GCT) level during pregnancy.

MATERIALS AND METHODS

We collected prenatal information of women who had their first clinic visit in early pregnancy. Women underwent GCT at 24-28 gestational weeks, and a result of ≥7.8 mmol/L was considered positive. Participants were divided into quartiles of leukocyte counts, and association with GCT results and positive rate were analyzed by logistic regression.

RESULTS

Among 20,707 pregnant women, the median of leukocyte counts was higher in the positive group than the normal group (8.5 × 10 /L vs 8.2 × 10 /L, P < 0.01). There was a linear trend in GCT results and positive rate with increasing leukocyte quartiles. Compared with the lowest quartile, the highest leukocyte quartile (>9.70 × 10 /L) was significantly associated with positive GCT results (adjusted odds ratio 1.378, 95% confidence interval 1.246-1.524), and the linear relationship between increased risk of positive result and increasing leukocyte quartiles persisted (P for linear trend <0.01). In multivariable analysis, the risk of a positive result increased by 2.2% with each 1-unit increase in leukocyte counts (adjusted odds ratio 1.022, 95% confidence interval 1.011-1.033).

CONCLUSIONS

Elevated leukocyte counts in early pregnancy were independently and linearly associated with the risk of positive GCT levels, indicating that inflammation might play an important role in the development of gestational diabetes mellitus.

摘要

目的/引言:我们研究了怀孕期间白细胞计数与葡萄糖挑战试验(GCT)水平之间的关系。

材料和方法

我们收集了在孕早期首次就诊的女性的产前信息。女性在 24-28 孕周时进行 GCT,如果结果≥7.8mmol/L,则被认为是阳性。参与者的白细胞计数被分为四等份,通过 logistic 回归分析白细胞计数与 GCT 结果和阳性率的关系。

结果

在 20707 名孕妇中,阳性组的白细胞计数中位数高于正常组(8.5×10 /L 比 8.2×10 /L,P<0.01)。GCT 结果和阳性率随着白细胞四分位数的增加呈线性趋势。与最低四分位数相比,白细胞最高四分位数(>9.70×10 /L)与 GCT 阳性结果显著相关(调整后的优势比 1.378,95%置信区间 1.246-1.524),并且随着白细胞四分位数的增加,阳性结果的风险呈线性增加的趋势仍然存在(P<0.01)。在多变量分析中,白细胞计数每增加 1 个单位,阳性结果的风险增加 2.2%(调整后的优势比 1.022,95%置信区间 1.011-1.033)。

结论

孕早期白细胞计数升高与 GCT 水平阳性的风险独立且呈线性相关,这表明炎症可能在妊娠期糖尿病的发生发展中发挥重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0195/8756326/c423ba5b847e/JDI-13-191-g001.jpg

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