CAJ | 학술논문

目的探讨北京地区孕期糖代谢异常患者产后1年糖、脂代谢的转归.方法 2007年2月至12月于本院分娩,并分别于产后6～12周及产后1年于本院复诊的患者73例,年龄(32.0±3.6)岁.妊娠糖尿病46例(63％),妊娠期糖耐量受损(GIGT)27例(37％).所有患者均就诊于妊娠糖尿病产后随访门诊,分别于产后6～12周及产后1年进行随访.了解体重变化,测量腰围、臀围,行口服葡萄糖耐量试验(OGTT)及血月脂检测.结果与产后6～12周相比,产后1年体重、腰围、臀围及腰臀比均出现有下降.产后1年与产后6～12周比较,空腹血糖(5.19±0.06)对(4.84±0.57) mmol/L(P＜0.01),6～12周无空腹血糖受损(IFG),1年后出现4例IFG;餐后血糖(6.84±1.93)对(7.33±1.50) mmol/L(P=0.017),糖耐量受损(IGT)发生率28.8％对38.4％ (P=0.167),其中6例6～12周餐后血糖正常者1年后出现IGT.与6 ～12周相比,产后1 年高甘油三酯血症更多(19.2％对13.7％),高胆固醇血症减少(19.7％对30.0％,P＜0.01),低高密度脂蛋白胆固醇(HDL-C)血症显著增加(21.9％对4.1％,P＜0.01),高低密度脂蛋白胆固醇(LDL-C)血症减少(21.9％对49.3％,P＜0.01). 无沦是产后6～12周或产后1年,妊娠期糖耐量受损及妊娠糖尿病两组间体重、体重指数、腰围、臀围及腰臀比均未见明显差异.结论妊娠糖尿病是育龄女性糖尿病患病率增加的重要原因.在体重、腰臀比等指标显著改善的情况下,妊娠糖尿病患者产后1年仍存在普遍的糖、脂代谢异常.
목적 탐토북경지구잉기당대사이상환자산후1년당、지대사적전귀.방법 2007년2월지12월우본원분면,병분별우산후6～12주급산후1년우본원복진적환자73례,년령(32.0±3.6)세.임신당뇨병46례(63％),임신기당내량수손(GIGT)27례(37％).소유환자균취진우임신당뇨병산후수방문진,분별우산후6～12주급산후1년진행수방.료해체중변화,측량요위、둔위,행구복포도당내량시험(OGTT)급혈월지검측.결과 여산후6～12주상비,산후1년체중、요위、둔위급요둔비균출현유하강.산후1년여산후6～12주비교,공복혈당(5.19±0.06)대(4.84±0.57) mmol/L(P＜0.01),6～12주무공복혈당수손(IFG),1년후출현4례IFG;찬후혈당(6.84±1.93)대(7.33±1.50) mmol/L(P=0.017),당내량수손(IGT)발생솔28.8％대38.4％ (P=0.167),기중6례6～12주찬후혈당정상자1년후출현IGT.여6 ～12주상비,산후1 년고감유삼지혈증경다(19.2％대13.7％),고담고순혈증감소(19.7％대30.0％,P＜0.01),저고밀도지단백담고순(HDL-C)혈증현저증가(21.9％대4.1％,P＜0.01),고저밀도지단백담고순(LDL-C)혈증감소(21.9％대49.3％,P＜0.01). 무륜시산후6～12주혹산후1년,임신기당내량수손급임신당뇨병량조간체중、체중지수、요위、둔위급요둔비균미견명현차이.결론 임신당뇨병시육령녀성당뇨병환병솔증가적중요원인.재체중、요둔비등지표현저개선적정황하,임신당뇨병환자산후1년잉존재보편적당、지대사이상.
Objective To elaborate the glucose and lipid metabolism 1 year postpartum on the foundation of postpartum 6-12 weeks in patients with prior gestational abnormal glucose metabolism in Beijing area.Methods Seventy-three patients who delivered during February to December,2007,aged (32.0 ± 3.6) years,were enrolled.46 cases (63％) were diagnosed as cases of gestational diabetes mellitus (GDM) while 27 (37％) as gestational impaired glucose tolerance (GIGT).All of the patients were revisited twice by 6-12 weeks and 1 year postparaum.Body weight,waist andhip circumferences,oral glucose tolerance test(OGTT),and lipids profile were determined.Results Compared with 6-12 weeks postpartum,the body weight,waist and hip circumferences,and waist-to-hip ratio were decreased by 1 year postpartum,fasting plasma glucose was increased [(5.19 ± 0.06) vs (4.84 ± 0.57) mmol/L,P＜0.01],and 4 cases were diagnosed as cases with impaired fasting glucose (IFG; 4 vs 0).By 6-12 weeks and 1 year postpartum,postprandial plasma glucose levels were (6.84± 1.93) and (7.33 ± 1.50) mmol/L(P=0.017),and the incidences of impaired glucose tolerance(IGT) were 28.8％ and 38.4％ (P=0.167),respectively,with 6 cases of newly diagnosed IGT by 1 year postpartum.There were more cases of hypertriglyceridenia (19.2％ vs 13.7％),less cases of hypercholesterolemia(19.7％ vs 30.0％,P＜0.01),more cases with improved high-densit.y lipoprotein-cholesterol (21.9％ vs 4.1％,P＜0.01),and less cases with raised low-density lipoproteincholesterol(21.9％ vs 49.3％,P＜0.01).No difference was found in body weight,body mass index,waist circumference,hip circumference,and waist-to-hip ratio between GIGT and GDM groups.Conclusion GDM is an important cause of the increasing prevalence of diabetes in women of reproductive age.Although body weight and waist-to-hip ratio have been improved,they would still develop glucose intolerance and dyslipidemia 1 year postpartum.