Abstract
陈逍天,叶莹,张羿,姜袁,王胤,陈红燕,窦亚兰,李梦茹,孙绪鹏,严卫丽.孕早期脂蛋白a水平与妊娠期糖尿病的前瞻性队列研究[J].Chinese journal of Epidemiology,2021,42(5):903-908
孕早期脂蛋白a水平与妊娠期糖尿病的前瞻性队列研究
Association of lipoprotein a in early pregnancy with gestational diabetes mellitus: a prospective cohort study
Received:August 04, 2020  
DOI:10.3760/cma.j.cn112338-20200804-01015
KeyWord: 妊娠期糖尿病  脂蛋白a  孕早期  队列研究
English Key Word: Gestational diabetes mellitus  Lipoprotein a  Early pregnancy  Cohort study
FundProject:国家重点研发计划(2016YFC1000506);中国医学科学院小儿遗传相关性心血管疾病早期防控创新单元(2018RU002);中国医学科学院医学与健康科技创新工程项目(2019-IZM-5-002)
Author NameAffiliationE-mail
Chen Xiaotian Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China  
Ye Ying Department of Dermatology, Children's Hospital of Fudan University, Shanghai 201102, China  
Zhang Yi Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China  
Jiang Yuan Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China  
Wang Yin Department of Clinical Trial Unit, Children's Hospital of Fudan University, Shanghai 201102, China  
Chen Hongyan Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China  
Dou Yalan Department of Clinical Trial Unit, Children's Hospital of Fudan University, Shanghai 201102, China  
Li Mengru Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China  
Sun Xupeng Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China  
Yan Weili Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China
Department of Clinical Trial Unit, Children's Hospital of Fudan University, Shanghai 201102, China 
yanwl@fudan.edu.cn 
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Abstract:
      目的 探讨孕早期脂蛋白a(Lpa)水平与妊娠期糖尿病(GDM)的关系。方法 以“母体关键营养素与子代特应性皮炎”队列中的445名孕12~14周孕妇为研究对象,通过问卷调查收集一般人口学特征,检测孕早期空腹糖脂代谢指标,随访孕24~28周口服糖耐量试验(OGTT)结果。应用多因素logistic回归分析Lpa水平与GDM的关系,计算OR值及其95%CI结果 孕中期GDM发病人数为78人(17.5%)。GDM孕妇孕早期Lpa水平[105.5 (92.0,122.0) mg/L]高于非GDM孕妇[97.0(87.0,109.0) mg/L],差异有统计学意义(P<0.05)。Lpa每升高10 mg/L,GDM发生风险增加21%,OR值(95%CI)为1.21(1.08~1.36),P<0.05;校正年龄、孕周等协变量后,关联仍有统计学意义,校正OR值(95%CI)为1.14(1.01~1.30),P=0.03。结论 孕早期Lpa水平升高可能是GDM发生的危险因素之一,维持正常Lpa水平可能有助于GDM早期预防、提高子代健康水平。
English Abstract:
      Objective To investigate the association of lipoprotein a (Lpa) in early pregnancy with gestational diabetes mellitus (GDM) risk. Methods A total of 445 pregnant women in 12-14 gestational weeks from "Maternal Key Nutritional Factors and Offspring's Atopic Dermatitis" cohort were included in this study. The demographic characteristics of participants were collected by using questionnaires, and the fasting glucose and lipids levels in early pregnancy were measured. The results of oral glucose tolerance test (OGTT) between 24-28 gestational weeks were recorded. Multivariate logistic regression model was applied to analyze the association of Lpa with GDM by calculating the OR and 95%CI after adjustment for covariates. Results The incidence number of GDM was 78 (17.5%). The Lpa level in pregnant women with GDM was significantly higher than that in pregnant women without GDM[105.5 (92.0, 122.0) vs. 97.0 (87.0, 109.0) mg/L], P<0.05. Lpa was significantly associated with GDM risk[OR (95%CI)=1.21(1.08-1.36) per 10 mg/L], P<0.05. The association was still significant after adjustment for covariates including age, gestational weeks et al, the adjusted OR was 1.14 (95%CI:1.01-1.30), P=0.03. Conclusions The elevation of Lpa in early pregnancy is one of risk factor for GDM. Maintaining normal Lpa level during early pregnancy can benefit early prevention of GDM and offspring health.
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