摘要目的:探讨孕妇体成分及相关因素在妊娠期糖尿病（GDM）早期筛查中的预测价值。方法:回顾性纳入2019年3月至2020年3月苏州市立医院949例（GDM组142例；正常组807例）孕妇，于孕13周采用生物电阻抗法测定体成分及相关因素，包括年龄、蛋白质、基础代谢率、孕前体质指数（BMI）、脂肪质量指数（FMI）、体脂百分比、孕次等与妊娠中期糖耐量筛查结果之间的关系。采用多因素Logistic回归探讨GDM的危险因素，并绘制受试者工作特征曲线，评价FMI对GDM的诊断价值。结果:GDM组的年龄（29.82±3.92比31.24±4.31）、孕前BMI（20.82±2.60比22.35±3.64）、体脂百分比（29.37±5.63比32.14±5.77）、FMI［6.06（5.00，7.30）比6.87（5.60，8.60）］、孕次［1（1，2）比2（1，3）］均高于正常组。多因素Logistic回归模型分析显示，孕次（ OR=1.232，95% CI：1.033~1.471）及FMI（ OR=1.228，95% CI：1.057~1.426）均为GDM的独立危险因素。FMI预测GDM的曲线下面积为63.0%。 结论:孕次及妊娠早期FMI可作为GDM独立的预测因子。通过科学调整膳食结构及合理运动来降低FMI，从而减少孕妇GDM的发病风险。

abstractsObjective:Explore the predictive value of body composition and related factors in early detection of gestational diabetes mellitus (GDM).Methods:949 pregnant women (142 cases in GDM group and 807 cases in normal group) in early pregnancy were selected from March 2019 to March 2020 in Suzhou Municipal Hospital, subject's clinical data were recorded. Body composition was measured by bioelectrical impedance method before the 13th week of pregnancy, and the relationship between age, protein, basal metabolic rate, body mass index (BMI) before pregnancy, body fat percentage, fat mass index (FMI), pregnancy times and the screening results of glucose tolerance in the second trimester of pregnancy were analyzed. The risk factors of GDM were further identified by multivariate regression analysis. Finally, the ROC curve was drawn to determine the diagnostic value of GDM, and the best boundary value was found to calculate the sensitivity and specificity of the indicators.Results:The age (20.82±2.60 vs 22.35±3.64), BMI before pregnancy (20.82±2.60 vs 22.35±3.64), percentage of body fat (29.37±5.63 vs 32.14±5.77), FMI [6.06(5.00, 7.30) vs 6.87(5.60, 8.60)] and pregnancy times [1(1, 2)vs 2(2, 3)] in GDM group were higher than those in normal group. Pregnancy times ( OR=1.232, 95% CI: 1.033-1.471) and FMI ( OR=1.228, 95% CI: 1.057-1.426) are independent risk factors of GDM. When FMI was used to predict the incidence of GDM, the area under the curve (AUC) was 63.0%. Conclusion:Pregnancy times and FMI in early pregnancy can be used as independent predictors of GDM. They provide a basis for scientific adjustment of diet and reasonable exercise, thereby preventing the GDM as early as possible. FMI can be reduced by adjusting the dietary structure and engaging in reasonable exercise, to reduce its risk among pregnant women.