【摘 要】
：
目的 妊娠期糖尿病(GDM)患者产后体重变化特点尚不清晰.本研究旨在探讨GDM与非GDM产妇产后1年的体重滞留差异以及体脂在其中的作用.方法 采用前瞻性队列研究设计,通过75 g口服葡萄糖耐量试验(OGTT)进行GDM诊断,采用双能X骨密度仪(DXA)测量产后6个月时体脂含量并获取脂肪质量指数(FMI),并随访至产后1年测量体重.利用Log-binomial回归模型进行多因素分析.结果 ①810名产妇在产后1年时的体重变化平均为(2.1±4.2)kg,其中GDM和非GDM产妇平均体重增加分别为(0.9±4
【机 构】
：
广州市妇女儿童医疗中心广州医科大学,广东广州510623
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目的 妊娠期糖尿病(GDM)患者产后体重变化特点尚不清晰.本研究旨在探讨GDM与非GDM产妇产后1年的体重滞留差异以及体脂在其中的作用.方法 采用前瞻性队列研究设计,通过75 g口服葡萄糖耐量试验(OGTT)进行GDM诊断,采用双能X骨密度仪(DXA)测量产后6个月时体脂含量并获取脂肪质量指数(FMI),并随访至产后1年测量体重.利用Log-binomial回归模型进行多因素分析.结果 ①810名产妇在产后1年时的体重变化平均为(2.1±4.2)kg,其中GDM和非GDM产妇平均体重增加分别为(0.9±4.4)kg和(2.3±4.1) kg.GDM产妇的产后体重滞留率低于非GDM产妇(11.9％vs 26.4％,P=0.0003).②单因素分析显示,GDM与产后体重滞留发生风险存在负相关(RR =0.45,95％ CI:0.28 ～0.72);而产后6个月脂肪质量指数(FMI)高则增加产后体重滞留风险(RR=1.92,95％ CI:1.48 ～2.49).③多因素分析显示,在调整了可能的混杂因素之后,GDM(RR =0.47,95％ CI:0.28 ～ 0.78)和产后高FMI(RR =3.48,95％ CI:2.60 ～ 4.66)与产后体重滞留之间的关联仍然具有统计学意义.④无论产前是否诊断为GDM,高体脂产妇的产后体重滞留率均是正常体脂产妇的2倍.结论 广州地区GDM患者的产后体重滞留率处于较低水平,而非GDM产妇亟需加强体脂控制及体重管理.
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