GESTATIONAL DIABETES-MELLITUS - INFLUENCE OF RACE ON DISEASE PREVALENCE AND PERINATAL OUTCOME IN A UNITED-STATES POPULATION
GESTATIONAL DIABETES-MELLITUS - INFLUENCE OF RACE ON DISEASE PREVALENCE AND PERINATAL OUTCOME IN A UNITED-STATES POPULATION
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DOI：
10.2337/diab.40.2.s25
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发表时间：
1991-12-01
期刊：
影响因子：
7.7
通讯作者：
CHO, NH
中科院分区：
文献类型：
--
作者：
DOOLEY, SL;METZGER, BE;CHO, NH
我们探讨美国人口的种族差异是否影响妊娠期糖尿病（GDM）的患病率和围产期结局。所提供的数据基于 3744 名在妊娠 24-28 周接受普遍筛查的连续患者； 1 小时血浆葡萄糖大于或等于 7.2 mM 的患者接受 100 g 3 小时口服葡萄糖耐量试验 (OGTT)。根据源自血浆的标准 O'Sullivan-Mahan 诊断标准，GDM 的总体患病率为 3.5 例/100，而使用 O'Sullivan-Mahan 标准的 Carpenter-Coustan 修改版得出的患病率为 5.5。人口中 39.1% 为白人，37.7% 为黑人，19.8% 为西班牙裔，3.4% 为东方/其他种族。对于那些进行非诊断性测试的患者，所有种族组在 OGTT 每个时间点的平均血浆葡萄糖相似。由于不同种族群体之间的人口和表型异质性，这些不同变量对 GDM 患病率的影响通过多元逻辑回归进行了检验。研究发现黑人和西班牙裔人种、母亲年龄和理想体重百分比对 GDM 患病率具有显着的独立影响（分别为 P < 0.05、0.001、0.001 和 0.001）。与白人相比，黑人（1.81，95%置信区间[Cl] 1.13-2.89，P < 0.05）和西班牙裔（2.45，95% CI 1.48-4.04，P < 0.001）患者的GDM调整后相对风险显着较高。在 92 名饮食控制的 GDM 患者中研究了种族对婴儿出生体重的影响。尽管不同种族群体的碳水化合物不耐受程度相当，但西班牙裔的平均出生体重最高，黑人和东方人的平均出生体重最低。通过协方差分析，发现种族对出生体重有显着的独立影响（P = 0.017），母亲理想体重百分比是显着的协变量（P = 0.009）。这些结果表明，在比较不同人群中 GDM 的患病率并评估特定治疗干预措施对围产期结局的影响时，必须考虑种族以及母亲年龄和肥胖程度。
We explore whether racial differences in a United States population influence disease prevalence and perinatal outcome in gestational diabetes mellitus (GDM). The data presented are based on 3744 consecutive patients who underwent universal screening at 24-28 wk gestation; those with a 1-h plasma glucose greater-than-or-equal-to 7.2 mM underwent a 100-g 3-h oral glucose tolerance test (OGTT). The overall prevalence of GDM was 3.5 cases/100 with the standard O'Sullivan-Mahan diagnostic criteria derived for plasma, whereas use of the Carpenter-Coustan modification of the O'Sullivan-Mahan criteria yielded a prevalence of 5.5. The population was 39.1% white, 37.7% black, 19.8% Hispanic, and 3.4% Oriental/other. For those patients with a nondiagnostic test, mean plasma glucose at each time point of the OGTT was similar for all racial groups. Because of demographic and phenotypic heterogeneity between different racial groups, the influence of these different variables on the prevalence of GDM was tested by multiple logistic regression. Black and Hispanic race, maternal age, and percentage ideal body weight were found to have significant independent effects on the prevalence of GDM (P < 0.05, 0.001, 0.001, and 0.001, respectively). The adjusted relative risk of GDM was significantly higher in black (1.81, 95% confidence interval [Cl] 1.13-2.89, P < 0.05) and Hispanic (2.45, 95% Cl 1.48-4.04, P < 0.001) patients compared with whites. The influence of race on infant birth weight was examined in the 92 patients with GDM controlled with diet. Despite comparable degrees of carbohydrate intolerance across racial groups, mean birth weight was found to be highest in Hispanics and lowest in blacks and Orientals. By analysis of covariance, race was found to have a significant independent effect on birth weight (P = 0.017), with maternal percentage ideal body weight a significant covariate (P = 0.009). These results suggest that race as well as maternal age and degree of obesity must be taken into account when comparing the prevalence of GDM in different populations and assessing the impact of specific therapeutic interventions on perinatal outcome.