第一临床医学院知识库

目的：分析兰州市中老年女性的不同生育经历和不同糖代谢状况，探讨女性经产数与不同糖代谢状况的相关性。
方法：本流行病学研究采用整群随机抽样方法，利用“REACTION研究”甘肃省的基线资料，选取兰州市社区45-70岁符合标准的女性居民进行研究。提取资料中相关的问卷调查、体格检查和实验室检查等指标。根据研究对象的经产数分为P1（0-1次）、P2(2次)、P3(3次)、P4(≥4次)共四组，统计并分析该人群的不同生育经历和不同糖代谢状况，并探讨经产数与不同糖代谢状态的相关性。
结果：（1）共有6246例研究对象，经产数为P1、P2、P3、P4分别占54.9%、24.2%、12.6%、7.7%。（2）正常糖耐量（NGT）、糖调节受损（IGR）、糖尿病（DM）分别占50.5%、28.5%、21.0%，其中49.5%的研究对象存在糖代谢异常。（3）Sperman相关分析示：年龄、腰围、BMI、高血压、血脂异常、月经初潮年龄、经产数、与FPG和2hPG正相关；绝经年龄与FPG正相关，与2hPG不相关；巨大胎儿史与FPG和2hPG负相关。（4）Logistic回归分析显示：在未调整混杂因素的情况下，经产数与糖尿病的患病风险呈正相关；在上述基础上，调整了年龄、月经初潮年龄、绝经年龄、巨大胎儿史等生育相关因素后，上述相关性虽然稍有减弱，但仍存在统计学差异(P<0.05 )；进一步调整婚姻状况、独居条件、文化程度、高血压、血脂异常、BMI等因素后，相对于经产数为P1，经产数为P2、P3、P4的糖尿病患病风险逐渐增加，差异有统计学意义（P<0.05）。
结论：1.女性经产数、月经初潮年龄与FPG和2hPG正相关，巨大胎儿史与FPG和2hPG负相关。 2.女性经产数增加与糖尿病患病风险呈正相关。

Objective:To analyze the different reproductive experiences and glucose metabolism of middle-aged and elderly women in Lanzhou, and to explore the relationship between women parity and different glucose metabolic status.
Method:This epidemiological study adopting cluster random sampling method and using the "REACTION research" baseline data of Gansu province. This study selecting female residents aged 45-70 years old who met the standard in Lanzhou community. The related questionnaire, physical examination and laboratory examination were collected. According to the research object of the parity divided into P1 (0-1), P2 (2), P3 (3), P4 (over 4 times) a total of four groups, statisticed and analysised the different reproductive experiences and glucose metabolism status, and then discussed the correlation between the number of parity and different glucose metabolism status.
Results:(1) There were 6246 subjects in the study, the number of P1 and P2, were P3 and P4 respectively accounted for 54.9%, 24.2%, 12.6%, 7.7%. (2) Normal glucose tolerance (NGT), impaired glucose regulation (IGR), and diabetes (DM) accounted for 50.5%, 28.5%, and 21%, respectively, of which 49.5% of the subjects had abnormal glucose metabolism. (3) Sperman correlation analysis showed that age, waist circumference, BMI, hypertension, dyslipidemia, age of menarche, number of menstruation, and positive correlation with FPG and 2hPG; menopause age is positively related to FPG and not related to 2hPG; the history of fetal macrosomia is negatively related to FPG and 2hPG. (4) Logistic regression analysis showed that in the case of unadjusted miscellaneous factors, the number of menstruation is an independent risk factor for diabetes. On the basis of these factors, the correlation of age, menarche age, menopause age, fetal history and other fertility factors has been slightly weakened, but there is still a statistical difference (P<0.05); after further adjustment of the marital status, living conditions, education, hypertension, blood lipid abnormality, BMI and other factors, the risk of diabetes in P2, P3 and P4 increased gradually compared with the parity of P1, and the difference was statistically significant (P<0.05).
Conclusion:1. female parity, menarche age is positively related to FPG and 2hPG, the history of fetal macrosomia was negatively correlated with FPG and 2hPG. 2. female parity associated with diabetes risk was increased.