CAJ | 학술논문

目的探讨妊娠初期外周血白细胞(WBC)计数与随后发生的妊娠糖尿病(GDM)的相关性.方法在妊娠初期检测孕妇的外周血WBC计数,将以后发生GDM的232例作为病例组,糖耐量正常的482名孕妇作为对照组,比较两组的WBC计数;再按WBC计数四分位,从而将研究对象分为四组,进行Logistic回归分析.结果病例组的妊娠初期外周血WBC计数明显高于对照组(8.56×109/Lυs8.18×109/L,P<0.01).根据WBC计数四分位的结果,将研究对象分为四组,第一组WBC<7.46×109/L,第二组WBC(7.46～8.33)×109/L,第三组WBC(8.34～9.16)×109/L,第四组WBC≥9.17×109/L,相应的GDM的检出率分别为20.13%、34.61%、36.02%、39.61%.调整年龄、孕次、孕前BMI、SBP、DBP及糖尿病家族史等因素,行Logistic回归发现,相对于第一组而言,第二组、第三组及第四组发生GDM的危险分别是第一组的2.17倍(95%CI 1.25～3.77)、2.15倍(95%CI 1.23～3.76)及2.59倍(95%CI 1.49～4.50).结论 GDM患者妊娠初期WBC计数升高,慢性炎症可能参与了GDM的发生.
목적 탐토임신초기외주혈백세포(WBC)계수여수후발생적임신당뇨병(GDM)적상관성.방법 재임신초기검측잉부적외주혈WBC계수,장이후발생GDM적232례작위병례조,당내량정상적482명잉부작위대조조,비교량조적WBC계수;재안WBC계수사분위,종이장연구대상분위사조,진행Logistic회귀분석.결과 병례조적임신초기외주혈WBC계수명현고우대조조(8.56×109/Lυs8.18×109/L,P<0.01).근거WBC계수사분위적결과,장연구대상분위사조,제일조WBC<7.46×109/L,제이조WBC(7.46～8.33)×109/L,제삼조WBC(8.34～9.16)×109/L,제사조WBC≥9.17×109/L,상응적GDM적검출솔분별위20.13%、34.61%、36.02%、39.61%.조정년령、잉차、잉전BMI、SBP、DBP급당뇨병가족사등인소,행Logistic회귀발현,상대우제일조이언,제이조、제삼조급제사조발생GDM적위험분별시제일조적2.17배(95%CI 1.25～3.77)、2.15배(95%CI 1.23～3.76)급2.59배(95%CI 1.49～4.50).결론 GDM환자임신초기WBC계수승고,만성염증가능삼여료GDM적발생.
Objective To investigate the relationship between peripheral white blood cell (WBC) of the first trimester and the subsequent development of gestational diabetes mellitus (GDM). Methods WBC levels in first trimester were measured in 232 women who subsequently developed GDM and in 482 women who remained euglycemic throughout pregnancy. WBC median levels were compared between two groups using Wilcoxon’s rank-sum test. Logistic regression was used to compute the unadjusted and multivariable-adjusted odds ratios for developing GDM among WBC quartile grouping. Results First trimester WBC levels were significantly increased among women who subsequently developed GDM as compared with control subjects (8.56×109/L vs 8.18×109/L,P＜0.01). The minimum-maximum values of white blood cell count for the first to the fourth quartile were ［（2.94～7.46）×109/L］,［（7.47～8.33）×109/L］,［（8.34～9.16）×109/L］,［（9.17～9.99）×109/L］, respectively.Detection rate of GDM for the respective quartiles were 20.13%，34.61%，36.02%，39.61%.After adjusting for age, parity, family history of diabetes, pregestational body mass index, and blood pressure, the relative risk was 2.17 (95%CI 1.25～3.77) for the second and 2.15 (95%CI 1.23～3.76) for the third and 2.59 (95%CI 1.49～4.50) for the fourth guartile of WBC as compared with the first quartile. Conclusion sIn women who develop GDM, there is evidence of increased WBC count early in pregnancy. Systemic inflammation may be associated with the development of GDM.