妊娠糖尿病與罹患第2型糖尿病之相關性研究

A Relational Study of Gestational Diabetes and Type 2 Diabetes

10.6288/TJPH2006-25-02-07

何雪華(Hsueh-Hua Ho)；謝碧晴(Pi-Ching Hsieh)；李中一(Chung-Yi Li)；蘇慧芳(Hui-Fang Su)

妊娠糖尿病 ； 第2型糖尿病 ； 冠狀動脈心臟病 ； 發生率 ； 危險因子 ； gestational diabetes mellitus GDM ； type 2 diabetes ； coronary heart disease ； incidence ； predicting factors

台灣公共衛生雜誌

25卷2期（2006 / 04 / 01）

143 - 151

繁體中文

目標：本研究目的為探討1998年至2002年間的妊娠糖尿病婦女罹患第2型糖尿病之發生率及影響這群婦女日後罹患第2型糖尿病的預測因子並進一步比較不同血糖狀況者冠狀動脈心臟病相關危險因子的差異情形。方法：本研究先以非同期性世代研究設計，追蹤1998年至2002年間台北市某醫學中心共有558位妊娠糖尿病婦女，於2003年5月至6月電話及郵寄通知婦女返院參加「妊娠糖尿病婦女回娘家」活動，填寫妊娠糖尿病問卷及抽血檢查。除以StatXact 4.0分析第2型糖尿病發生密度，並利用SPSS 11.0分別進行描述性統計、t檢定、K-W檢定、及多名義邏輯斯複迴歸分析。結果：共有152位妊娠糖尿病婦女返院接受檢查，其中有10位罹患糖尿病，另有5位在本研究進行之前已罹患糖尿病患，故共有9.6罹患糖尿病，發生密度為2.5/千人年，另有13.8%處於糖尿病前期。罹患第2型糖尿病的預測因子包括懷孕前的身體質量指數和懷孕時100g葡萄糖耐受試驗第1小時之血糖值；研究也發現罹患糖尿病婦女在冠狀動脈心臟病相關危險因子之空腹血糖、75g OGTT 2小時之胰島素及血糖、糖化血色素、三酸甘油酯、目前的身體質量指數、腰圍、腰臀比、體脂肪和收縮壓等變項分佈也與未罹患糖尿病婦女不同。結論：本研究發現妊娠糖尿病婦女產後罹患第2型糖尿病之發生率及預測因子與國外研究結果部份雷同；產後罹患第2型糖尿病婦女比未罹患糖尿病婦女具有較多的冠狀動脈心臟病的危險因子。

Objectives: The purposes of this study were to investigate the factors impacting the women with gestational diabetes mellitus (GDM) developing type 2 diabetes and its incidence density and to compare the differences between developing type 2 diabetes and non-developing type 2 diabetes in risk factors of coronary heart disease. Method: Based on a non-concurrent cohort study design, we got a total of 558 women with GDM and delivered to a medical center in Taipei from 1998 to 2002. We invited them to participate in the activity of ”Come Back Home for Women with GDM” through telephone and mailing from May to June of 2003. Participants were asked to complete the questionnaire and finish the blood test when they came back. The StatXact 4.0 was used to analyze the incidence density of type 2 diabetes. In addition, we presented the descriptive analysis, t-test, K-W test, and Multivariate Logistic Regression analysis using SPSS 11.0. Results: 152 GDM women had been followed, 10 of whom developed diabetes, the other 5 women had been diagnosed with diabetes before this research, so that the diabetes incidence came up to 9.6%. The incidence density of diabetes during the years from 1998 to 2002 was 2.5‰ person year, and the predicting factors of developing type 2 diabetes were ”pre-pregnant body mass index” and ”the plasma glucose value of 100g oral glucose tolerance test (OGTT) in the first hour during pregnancy”. There was a significant association between developing type 2 diabetes and non-developing type 2 diabetes in risk factors of coronary heart disease, such as 75g OGTT 2-hour insulin and blood sugar, HbA1c, triglyceride, actual body mass index, waist circumstance, waist buttock ratio, body fat and systolic pressure. Conclusion: The findings reveal that the incidence density of type 2 diabetes and its predictors of GDM women are similar with the findings from abroad. Developing type 2 diabetes women with GDM have higher risk factors of coronary heart disease than other non-GDM women.

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