Incidence and Risk Factors of Gestational Diabetes Mellitus: A Prospective Cohort Study in Qingdao, China.
Incidence and Risk Factors of Gestational Diabetes Mellitus: A Prospective Cohort Study in Qingdao, China.
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妊娠糖尿病的发病率和危险因素：中国青岛的一项前瞻性队列研究
DOI：
10.3389/fendo.2020.00636
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发表时间：
2020
影响因子：
5.2
通讯作者：
Xing Q
中科院分区：
文献类型：
--
作者：
Li G;Wei T;Ni W;Zhang A;Zhang J;Xing Y;Xing Q
背景：肥胖和产妇年龄是影响妊娠期糖尿病（GDM）风险的两个最重要的独立因素。然而，肥胖和GDM之间的年龄差异仍不清楚。本队列研究的目的包括：(1)确定青岛市GDM的当前发病率；(2)评估GDM的危险因素，如孕前体重指数（BMI）与年龄的相互作用。方法：该队列包括2018年8月1日至2019年3月1日期间在15至20孕周登记的17,145名孕妇。在妊娠24-28周时，对每位受试者进行75 g 2小时口服葡萄糖耐量试验（OGTT）。采用logistic回归计算经年龄调整的GDM发病率。采用多因素logistic回归分析确定危险因素。采用分层分析确定年龄（参照组<30岁）与BMI（参照组<25 kg/m2）之间的相互作用。结果：青岛市GDM的发病率为17.42%，年龄调整后的发病率为17.45%。各孕前BMI组GDM的发生率均随年龄增长而稳步增加（P < 0.05）。年龄较大（≥30岁）、孕前至妊娠15-20周的妊娠BMI增加、GDM史和甲状腺疾病是GDM的危险因素。在校正其他混杂因素后，孕前BMI与年龄之间存在显著的相互作用（P < 0.05）。<30岁、30 ~ 34岁和≥35岁孕前BMI≥30 kg/m2的比值比（OR）分别为1.30 （95% CI: 0.74 ~ 2.28, P = 0.36）、3.21 （95% CI: 2.28 ~ 4.52, P < 0.0001）和1.55 （95% CI: 1.02 ~ 2.36, P = 0.0424）。这表明孕前BMI≥30 kg/m2对30 - 34岁组GDM的影响强于30岁以下组。结论：青岛市GDM发病率较高。怀孕前的超重和肥胖、怀孕至15-20周的妊娠期体重指数增加以及更大的年龄与GDM风险增加相关。公共卫生措施可能有助于防止妊娠期体重过度增加。
Background: Obesity and maternal age are the two most important factors independently affecting the risk of gestational diabetes mellitus (GDM). However, the age differences in the association between obesity and GDM remain unclear. The objectives of this cohort study included: (1) to determine the current incidence of GDM in Qingdao; and (2) to evaluate the risk factors for GDM, such as the interaction between pre-pregnancy body mass index (BMI) and age. Methods: The cohort included 17,145 pregnant women who registered at 15 to 20 gestational weeks from August 1, 2018, to March 1, 2019. A 75-g 2-h oral glucose tolerance test (OGTT) was conducted for each participant at 24–28 gestational weeks. The age-adjusted incidence of GDM was calculated using logistic regression. Multivariate logistic regression analysis was used to identify risk factors. Interaction between age (reference group <30 years) and BMI (reference group <25 kg/m2) was determined using strata-specific analysis. Results: The incidence and age-adjusted incidence of GDM in Qingdao were 17.42 and 17.45%, respectively. The incidence of GDM appeared to increase steadily with age in all pre-pregnancy BMI groups (all P < 0.05). Older age (≥30 years), gestational BMI gain from pre-pregnancy to 15–20 weeks of gestation, history of GDM and thyroid diseases were risk factors for GDM. There were significant interactions between pre-pregnancy BMI and age (P < 0.05) after adjustment for other confounders. The odds ratio (OR) of pre-pregnancy BMI ≥ 30 kg/m2 at the age of <30 years, 30–34 years and ≥35 years was 1.30 (95% CI: 0.74–2.28, P = 0.36), 3.21 (95% CI: 2.28–4.52, P < 0.0001) and 1.55 (95% CI: 1.02–2.36, P = 0.0424), respectively. This indicated that pre-pregnancy BMI ≥ 30 kg/m2 had a stronger effect on GDM in the group aged 30–34 years than those under 30 years old. Conclusions: The incidence of GDM was high in Qingdao. Overweight and obesity prior to pregnancy, gestational BMI gain from conception to 15–20 weeks of gestation and older age were correlated with an increased risk of GDM. Public health measures may be helpful to prevent excessive gestational weight gain.
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影响因子：
3.2
作者：
Gao C;Sun X;Lu L;Liu F;Yuan J
通讯作者：
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16.2
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12.7
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通讯作者：
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11.2
作者：
Bazzano, Lydia A.;Gu, Dongfeng;Whelton, Megan R.;Wu, Xiqui;Chen, Chung-Shluan;Duan, Xiufang;Chen, Jing;Chen, Ji-chun;He, Jiang
通讯作者：
He, Jiang