·糖尿病与妊娠·

　　【摘要】 目的 探讨GDM患者孕晚期血清UA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周检测其血清UA浓度分为UA≤220、221～264、265～334及>335 μmol/L组，产后6～8周检测75 gOGTT，并对血清UA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UA≤220 μmol/L组为14.36%(26/181)、(221～264) μmol/L组20.99%(38/181)、(265～334) μmol/L组27.07%(49/181)，>335 μmol/L组37.57%(68/181)。Logistic回归分析显示，GDM患者孕晚期血清UA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患者孕晚期血清UA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。

　　【关键词】 妊娠期糖尿病;尿酸;糖代谢异常

　　【Abstract】 Objective To explore the relationship between serum uric acid (UA) concentration in late pregnancy and postpartum glucose tolerance abnormality in patients with gestational diabetes mellitus (GDM). Methods 500 cases of GDM patients were divided into 4 groups : UA ≤220μmol/L,221～264 μmol/L, 265～334 μmol/L and >335 μmol/L according to the concentration of serum UA during 36～40 weeks. 75 gOGTT was tested at 6～8 weeks after delivery. The association between serum UA and postpartum glucose tolerance abnormality was analyzed by Logistic regression. Results The total postpartum abnormal glucose tolerance rate of these GDM patients was 36.2%. Logistic regression analysis showed that a positive association between the serum uric acid concentration in late pregnancy and postpartum glucose tolerance abnormality in GDM patience (β=0.658,P=0.000);the serum UA was an independent risk factor of postpartum glucose tolerance abnormality(OR：3.04,95%CI：2.13～3.95). Conclusions GDM patients with high level serum UA in late pregnancy may increase their risks of suffering from DM after delivery.

　　【Key words】 Gestational diabetes mellitus(GDM) ; Uric acid (UA); Glucose abnormal abonormality