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目的探讨妊娠期糖尿病(GDM)患者孕晚期血清尿酸(SUA)水平与产后糖代谢异常的相关性。方法选取孕中期确诊为GDM孕妇500例,于孕36~40周检测其SUA浓度分为SUA≤220、221~264、265~334及>335μmol/L组,产后6~8周检测75g OGTT,并对SUA与产后糖代谢异常的相关性行Logistic回归分析。结果孕妇产后6~8周糖代谢总异常率为36.2%(181/500),其中SUA≤220μmol/L组14.36%(26/181)、221~264μmol/L组20.99%(38/181)、265~334μmol/L组27.07%(49/181),>335μmol/L组37.57%(68/181)。Logistic回归分析显示,GDM患者孕晚期SUA水平与分娩后糖代谢异常呈正相关(β=0.658,P=0.000),是产后糖代谢异常的独立危险因素(OR:3.04,95%CI:2.13~3.95)。结论 GDM患者孕晚期SUA升高可能是分娩后患糖尿病的独立正相关风险因素,有必要对此类患者进行分级管理。
Objective To investigate the relationship between serum uric acid (SUA) levels and postpartum abnormal glucose metabolism in patients with gestational diabetes mellitus (GDM). Methods 500 pregnant women diagnosed as GDM in the second trimester of pregnancy were enrolled in this study. The concentrations of SUA in SUA≤202,221,264,265,334 and> 335μmol / L groups were detected at 36 to 40 weeks of gestation, and 75g OGTT at 6 to 8 weeks postpartum. Logistic regression analysis was performed on the correlation between SUA and postpartum abnormal glucose metabolism. Results The total rate of abnormal glucose metabolism was 36.2% (181/500) in 6 to 8 weeks postpartum in pregnant women, including 14.36% (26/181) in SUA≤220μmol / L group, 20.99% (38/181) in 221-264μmol / L group, 27.07% (49/181) in 265 ~ 334μmol / L group and 37.57% (68/181) in> 335μmol / L group. Logistic regression analysis showed that SUA level in third trimester of GDM patients was positively correlated with abnormal glucose metabolism after delivery (β = 0.658, P = 0.000), which was an independent risk factor for postpartum abnormal glucose metabolism (OR: 3.04, 95% CI: 2.13-3.95 ). Conclusions The elevated SUA in late pregnancy of GDM patients may be an independent and positively correlated risk factor for diabetes mellitus after delivery. It is necessary to manage the patients in different stages.