Correlative Analysis Of Gestational Diabetes Mellitus And Bone Mineral Density

Aim:The aim of this study is to analyse the correlation of some factors in gestational diabetes mellitus(GDM)and BMD(bone mineral density), define the risk factors of BMD in GDM and provide relevant scientific evidence for GDM to prevent the occurrence of osteoporosis.Method:To select the pregnant women who built cards and gave birth in MHC of Yangzhou city from 2012.6 to 2013.12. Based on the data got by monitoring weight and blood glucose which were carried out for the first time, measure the value of bone mineral density at the second trimester and the third trimester respectively; measure and record prenatal serum calcium, magnesium and phosphorus values in ob-stetrics. Conducting the study about the relevant influencing factors of BMD and bone mass in both normal blood glucose group and GDM group.Take the double entry method, duplicate data entry, and do the logic verification. Use SPSS 19.0 software for statistical analysis, using the T test, analysis of variance, linear dependence.Result:1. The age of GDM pregnant women, pre-pregnant BMI, second trimester BMI and its growth of weight, BMI before delivery and weight increase during pregnancy are higher than the levels of pregnant women with normal blood glucose. While there are not significant difference between the concentration of calcium, magnesium and phosphorus in the blood.2. The BMD value of woman in the second trimester is always higher than the BMD in the third trimester. Besides, to the same pregnant period, the BMD in the normal blood glucose group is higher than the GDM group.3. Comparing the bone density Z-score values of normal blood glucose group and GDM group, results show that the Z-score values of BMD of normal blood glucose group is higher than GDM group’s in the condition of normal bone mass.4. In both the normal blood glucose pregnancy women and GDM pregnancy women, the normal BMD of second trimester group’s (T≥-1) age, pre-pregnancy BMI and second trimester BMI are higher than the abnormal BMD of second trimester group’s(T<-1). While the value of fasting blood-glucose> 1-hour postprandial blood glucose and 2-hour postprandial blood glucose of normal BMD group is lower than abnormal BMD group, which indicated that age^ pre-pregnancy BMI, second trimester BMI and blood glucose level may have some influence on the BMD of GDM pregnancy women.5. In both normal blood glucose group and the GDM group, with the increase of BMI before pregnancy, the BMD in the second trimester has a tendency to increase.6. Take the T value of BMD in the second trimester as dependent variable (l=abnormal,2=normal), and take age, pre-pregnancy BMI, second trimester BMK fasting blood-glucose,1-hour postprandial blood glucose and 2-hour postprandial blood glucose as the independent variable for multiple unconditional Logistic regression analysis. Results show that in the normal blood glucose group, with age and second trimester BMI into regression equation, BMD T value in the second trimester is significantly positively correlated with age and the pre-pregnancy BMI(P=0.018、P=0.008), suggesting that age and pre-pregnancy BMI are the protective factors of BMD T value in the second trimester and pre-pregnancy BMI has the greater influence (B=0.219>B=0.096). While in the GDM group, with age, second trimester BMI, fasting blood-glucose,1-hour postprandial blood glucose and 2-hour postprandial blood glucose into regression equation, BMD T value in the second trimester is significantly positively correlated with the second trimester BMI(P=0.003),suggesting that second trimester BMI is the protective factors BMD T value in the second trimester.Besides, fasting blood-glucose,1-hour postprandial blood glucose and 2-hour postprandial blood glucose is significantly negatively correlated with BMD T value(P=0.000, P=0.019, P=0.001)and the fasting blood-glucose has the greatest influence on BMD T value(B=2.08),suggesting that the fasting blood-glucose,1-hour postprandial blood glucose and 2-hour postprandial blood glucose are the risk factors of BMD T value in the second trimester and the fasting blood-glucose has the greatest influence on BMD T value (B=2.08)7. Take T value of BMD in the third trimester as dependent variable (1=abnormal, 2=normal), and take age、BMI before delivery and the increase of weight during pregnancy as independent variable for unconditional Logistic regression analysis.Result shows that the age of pregnancy women into regression equation and it has significantly positively correlated with BMD T value in the third trimester(P=0.005, P=0.018),indicated that age is the protective factor of BMD T value in the third trimester and it has greater influence on the BMD T value of the third trimester of normal blood glucose women compared with GDM women.Conclusion:1. The BMD of GDM pregnant women is lower than the normal blood glucose pregnant women’s; Therefore, the prevention of GMD among pregnant women can be beneficial not only to the health of pregnant women and fetus, but also to the bone of pregnant women.2. Under the same pregnancy, the pregnant women is younger and bone mass have not reach the peak, the BMD of pregnant women has a tendency to decrease. If the GMD pregnant women is at the age of bone peak, the age is protective of the BMD, which suggests the research of the best age of pregnancy on the whole.3. The incidence of osteoporosis in GDM pregnant women has the tendency to increase with the increase of gestational age. The survey illustrates that early diagnosis, early detection and early prevention can reduce the incidence of osteoporosis in gestational diabetes.4. The blood glucose increased is the risk factor of BMD of GDM pregnant women,and through a variety of changes in the level of hormone influence the level of pregnant women, so the control blood sugar in suitable level, plays a positive role in maintaining good bone density.5. Controlling body weight in the normal range during pregnancy is not only one of the important measures to prevent the incidence of GDM, but also play a important role in maintaining BMD level.