孕早期甘油三酯葡萄糖-体质量指数与妊娠期糖尿病及围产结局的关系研究OA

Objectives:To explore the relationship between triglyceride-glucose-body mass index(TyG-BMI)in early pregnancy and gestational diabetes mellitus(GDM)as well as adverse pregnancy outcomes. Methods:A retrospective analysis was conducted on 272 singleton pregnant women who visited Maternal & Child Health Hospital of Songjiang District from January 2024 to January 2025.Fasting plasma glucose(FPG),triglycerides(TG),and BMI levels were measured in the early stages of pregnancy(10-14 weeks),and the TyG-BMI index was calculated.The pregnant women were divided into three groups based on the third quartile of the TyG-BMI index:Q1 group(TyG-BMI level＜158.98,n=90),Q2 group(TyG-BMI level:158.99-187.58,n=92),and Q3 group(TyG-BMI＞187.58,n=90).All pregnant women underwent a 75 g glucose tolerance test(OGTT)at 24-28 weeks of pregnancy to compare glucose and lipid metabolism related indicators between groups in early and mid pregnancy,and were followed up and recorded relevant indicators of perinatal outcomes.The multiple logistic regression analysis was used to investigate the relationship between TyG-BMI,GDM,and adverse perinatal outcomes. Results:The level of high-density lipoprotein cholesterol(HDL)in early pregnancy decreased with the increase of TyG-BMI,while age,early pregnancy BMI,FPG,TG,total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels increased with the increase of TyG-BMI,and there were significant differences among the groups(P＜0.05).The OGTT-FBG,OGTT-2 h plasma glucose levels and GDM incidence in Q3 group at second trimester were markedly higher than those in the other two groups(P＜0.05).The risk of hypertensive disorder complicating pregnancy(HDCP),cesarean section,and macrosomia in Q3 group was significantly higher than that in Q1 group(P＜0.05).Logistic regression analysis showed that,with Q1 as the reference group,the risk of GDM and HDCP significantly increased in the Q2 and Q3 groups(P＜0.05),and the risk of cesarean section and macrosomia also significantly increased in the Q3 group(P＜0.05). Conclusions:High TyG-BMI in early pregnancy is an independent risk factor for GDM and HDCP,and is significantly associated with increased risk of adverse perinatal outcomes such as macrosomia and cesarean section.TyG-BMI has important clinical application potential for identifying GDM and high-risk pregnant women.