Gestational Diabetes Prevalence at Moderate and High Altitude.
Gestational Diabetes Prevalence at Moderate and High Altitude.
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中高海拔地区妊娠糖尿病患病率。
DOI：
10.1089/ham.2018.0012
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发表时间：
2018
影响因子：
2.1
通讯作者：
Moore,LornaG
中科院分区：
文献类型：
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作者：
Euser,AnnaG;Hammes,Andrew;Ahrendsen,JaredT;Neshek,Barbara;Weitzenkamp,DavidA;Gutierrez,Javier;Koivunen,Peppi;Julian,ColleenG;Moore,LornaG
背景：与海平面相比，高海拔（HA）妊娠与血糖水平降低和胰岛素敏感性增加有关。我们的目的是确定妊娠期糖尿病（GDM）的患病率和人口统计学特征对GDM诊断的影响是否在中度海拔（MA）与HA.Methods不同：采用回顾性队列设计，我们比较了妇女生活在HA（>8250英尺）和MA（4000-7000英尺）在怀孕期间。排除标准如下：多胎妊娠、先前存在的糖尿病、GDM结果不可用或妊娠期间从不同海拔迁移。GDM诊断采用Carpenter和Coustan标准。数据比较采用字节检验（连续变量）或卡方检验（分类变量）。单因素，多因素，逐步回归模型被用来评估各种因素对GDM患病率的影响。结果：在这些人群中的海拔高度之间的GDM患病率没有差异，海拔高度和GDM之间的关系是不显着的所有回归分析。在MA，单变量分析中，孕妇年龄、西班牙裔、体重指数（BMI）和孕龄（GA）增加了GDM的发病率。在HA，产妇年龄，西班牙裔，和多产增加GDM发病率在单变量analysis.Conclusion：虽然GDM患病率MA和HA之间没有差异，产妇的人口统计学特征对GDM风险的影响不同的海拔组。较高的BMI和较大的GA在测试中增加了MA的GDM发病率，但不是在HA。多产对HA有影响，但对MA没有影响。这些差异可能代表HA时葡萄糖代谢的细微差异。
Background:High-altitude (HA) pregnancies have been associated with decreased glucose levels and increased insulin sensitivity versus sea level. Our objective was to determine if the prevalence of gestational diabetes mellitus (GDM) and the impact of demographic characteristics on GDM diagnosis differed at moderate altitude (MA) versus HA.Methods:Using a retrospective cohort design, we compared women living at HA (>8250 ft) and MA (4000–7000 ft) during pregnancy. Exclusion criteria were as follows: multiple gestation, preexisting diabetes, unavailable GDM results, or relocation from a different altitude during pregnancy. GDM diagnosis was determined using Carpenter and Coustan criteria. Data were compared byt-test (continuous variables) or chi-squared tests (categorical variables). Univariate, multivariate, and stepwise regression models were used to assess the impact of various factors on GDM prevalence.Results:There was no difference in GDM prevalence between altitudes in these populations; the relationship between altitude and GDM was nonsignificant in all regression analyses. At MA, maternal age, Hispanic ethnicity, body mass index (BMI), and gestational age (GA) at testing increased GDM incidence in univariate analyses. At HA, maternal age, Hispanic ethnicity, and multiparity increased GDM incidence in univariate analyses.Conclusion:While GDM prevalence did not differ between MA and HA, the impact of maternal demographic characteristics on GDM risk varied by altitude group. Higher BMI and greater GA at testing increased the incidence of GDM at MA, but not at HA. Multiparity had an effect at HA, but not MA. These differences may represent subtle differences in glucose metabolism at HA.