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首页> 外文期刊>Journal of diabetes. >Increasing insulin resistance predicts adverse pregnancy outcomes in women with gestational diabetes mellitus
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Increasing insulin resistance predicts adverse pregnancy outcomes in women with gestational diabetes mellitus

机译：增加胰岛素抵抗预测不利妊娠结局与妊娠期妇女糖尿病

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Abstract Background This study aimed to investigate the association between maternal insulin resistance (IR) in the late second trimester and pregnancy outcomes, as well as to identify risk factors of IR among women with gestational diabetes mellitus (GDM). Methods A retrospective study was conducted among 2647 women diagnosed with GDM. IR was evaluated using the homeostasis model assessment method for IR (HOMA‐IR) in the late second trimester (between 24 and 28?weeks), and the lipid profiles were measured at the same time. Patients were divided into groups based on quartiles of HOMA‐IR. The information on pregnancy outcomes and risk factors was extracted from the medical records of all participants and entered electronically. Logistic regression models were used to analyze the associations between HOMA‐IR and pregnancy outcomes, as well as the associations between risk factors and HOMA‐IR. Results Greater IR was associated with cesarean delivery, preterm delivery, macrosomia, and large for gestational age newborns, but only significantly associated with preterm delivery after adjustment for potential confounders ( P ??.001). Prepregnancy body mass index (BMI), weight gain before diagnosis of GDM, and triglycerides were significantly related with IR in the late second trimester ( P ??.001). Besides, the total area under the curve of the diagnostic 75‐g oral glucose tolerance test and glycosylated hemoglobin A1c increased from the lowest to the highest HOMA‐IR groups. Conclusions Increasing IR in the late second trimester predicts adverse pregnancy outcomes especially for preterm delivery in women with GDM. Additionally, prepregnancy BMI and weight gain before diagnosis of GDM are independent risk factors for the development of IR.
机译：摘要本研究旨在背景调查产妇之间的关系胰岛素抵抗(IR)在第二三个月和怀孕的结果,以及确定风险因素的红外女性妊娠糖尿病(GDM)。回顾性研究2647人之上女性患有GDM。红外的内稳态模型评估方法地理(HOMA IR)在怀孕中期(之间24日和28日?周)和血脂水平测量在同一时间。分成小组基于四分位数的HOMA IR。妊娠结局和风险的信息从医疗记录中提取的因素所有的参与者和进入电子。使用逻辑回归模型来分析HOMA IR和怀孕之间的关联结果,以及之间的关系风险因素和HOMA IR。与剖腹产有关,早产交付,巨大胎儿,大的妊娠时代的新生儿,但只有显著相关调整后与早产潜在的混杂因素(P & ?措施)。孕前体重指数(BMI),体重增加GDM的诊断之前,和甘油三酯显著相关的红外末第二三个月(P & ?措施)。曲线下的面积的诊断75 g口服葡萄糖耐量试验和糖化从最低到糖化血红蛋白增加最高HOMA IR组。在怀孕中期预测不利妊娠结果特别是早产交付与GDM的女性。诊断前孕前体重指数和体重增加GDM的独立的危险因素红外光谱的发展。

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