Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (01): 14 -18. doi: 10.3877/cma.j.issn.1673-5250.2019.01.003

Special Issue:

Original Article

Clinical significance of blood lipids detection in the third trimester pregnant women with gestational diabetes mellitus

Xiaoyan Han1, Huixia Yang2, Hua Yang1,()   

  1. 1. Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
    2. Beijing Rehabilitation Hospital of Capital Medical University, Beijing 100144, China
  • Received:2018-10-09 Revised:2019-01-02 Published:2019-02-01
  • Corresponding author: Hua Yang
  • About author:
    Corresponding author: Yang Hua, Email:
  • Supported by:
    Scientific Research Project of Clinical Medicine by Beijing Medical Association(2018-P2-010-01)
Objective

To study the clinical values of blood lipids concentrations detection in the third trimester pregnant women with gestational diabetes mellitus (GDM).

Methods

From January to December 2017, a total of 108 pregnant women in the third trimester who were diagnosed as GDM during routine prenatal care in Beijing Friendship Hospital, Capital Medical University were selected as research subjects and enrolled into observation group. Meanwhile, another 108 healthy pregnant women in the third trimester who received routine prenatal care in the same hospital during the same period were included into control group by random number table method. Concentrations of blood lipid indexes, such as serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were compared by independent-samples t test between two groups. According to gestational weight gain of GDM pregnant women in observation group, they were further divided into excessive weight gain subgroup, appropriate weight gain subgroup and underweight gain subgroup, and concentrations of blood lipid indexes among these three subgroups were compared by one-ANOVA method. This study protocol was in line with the Institutional Review Board of Beijing Friendship Hospital, Capital Medical University (Approval No. 2017-9-1), and clinical research consents were obtained from all participants.

Results

①There were no significant differences in age, gestational age and gestational weight gain between observation group and control group (P>0.05). ②Serum concentrations of TC, TG and LDL-C in observation group were (7.49±0.69) mmol/L, (3.64±0.56) mmol/L and (3.93±0.49) mmol/L, respectively, which were significantly higher than those (5.52±0.41) mmol/L, (2.13±0.39) mmol/L and (2.81±0.17) mmol/L, respectively in control group; but serum concentration of HDL-C in observation group was (1.62±0.22) mmol/L, which was significantly lower than that (1.96±0.16) mmol/L in control group, and all differences of serum concentrations of blood lipid indexes between observation group and control group were statistically significant (t=5.463, P<0.001; t=4.981, P<0.001; t=4.795, P<0.001; t=-2.736, P=0.007). ③Among the 108 pregnant women in the third trimester with GDM of observation group, 38, 42, and 28 cases were divided into excessive weight gain subgroup, appropriate weight gain subgroup and underweight gain subgroup, respectively. There were statistically significant differences among three subgroups in serum concentrations of TC, TG and LDL-C (F=8.587, P=0.020; F=6.164, P=0.030; F=14.266, P=0.001), and these three blood lipid indexes in excessive weight gain subgroup all were higher than those in appropriate weight gain subgroup and underweight gain subgroup. But there was no significant difference in serum concentration of HDL-C among three subgroups (P>0.05).

Conclusions

GDM women are more likely to have abnormal blood lipid metabolism, especially in those who have excessive gestational weight gain, and their serum concentrations of blood lipid indexes, such as serum concentrations of TC, TG and LDL-C are much higher in the third trimester pregnancy compared with healthy pregnant women. Obstetricians should strengthen the education of rational nutrition diet and weight management in GDM women, which not only helps to reduce serum concentrations of blood lipid indexes, such as serum concentrations of TC, TG and LDL-C of pregnant women with GDM in the third trimester, but also helps to reduce the incidences of perinatal complications and adverse pregnancy outcomes.

表1 观察组与对照组晚孕期孕妇一般临床资料比较(±s)
表2 观察组与对照组孕妇晚孕期血脂指标比较(mmol/L,±s)
表3 观察组3个亚组妊娠期糖尿病孕妇晚孕期血脂指标比较(mmol/L,±s)
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