Interaction between Abnormal Prepregnancy Body Mass Index and Hyperlipidemia during Pregnancy on the Risk of Gestational Diabetes Mellitus / 中国医学科学院学报

Objective To explore the interaction between abnormal prepregnancy body mass index(pBMI)and high blood lipid level during pregnancy on the risk of gestational diabetes mellitus(GDM). Methods A total of 235 patients with GDM and no blood lipid-related diseases before pregnancy were selected from Hangzhou Women's Hospital during March 2017 to July 2018 as the GDM group.At a ratio of 1∶3,a total of 705 individual age-matched pregnant women with normal glucose metabolism during prenatal examination from the same hospital were selected as the control group.The generalized multifactor dimension reduction(GMDR)method was employed to characterize the possible interaction between pBMI-blood lipid and GDM.The cross-validation consistency,equilibrium test accuracy,and P value were calculated to evaluate the interaction of each model. Results GMDR model analysis showed that the second-order model including pBMI and gestational blood lipid level had the best performance(P=0.001),with the cross-validation consistency of 10/10 and the equilibrium test accuracy of 64.48%,suggesting that there was a potential interaction between pBMI and gestational high blood lipid level.After adjustment of confounding factors,the model demonstrated that overweight/obesity patients with high triglyceride(TG) level had the highest risk of developing GDM(OR=14.349,95%CI=6.449-31.924,P<0.001).Stratified analysis showed that overweight/obesity patients under high TG level group had a higher risk of developing GDM than normal weight individuals(OR=2.243,95%CI=1.173-4.290,P=0.015). Conclusions Abnormal pBMI and high blood lipid level during pregnancy are the risk factors of GDM and have an interaction between each other.Overweight/obese pregnant women with high TG levels are more likely to develop GDM.

Application of temporal kurtosis index in assessing hearing loss caused by complex noise / 中国职业医学

Complex noise with impulse or impact property is common in workplace, and its damage on the auditory system is greater than that of steady-state noise. At present, the noise exposure measurement and evaluation indicators widely used in the world mainly include the equivalent continuous sound level and the cumulative noise exposure, both are based on the equal energy hypothesis(EEH). EEH only considered the damage of noise energy on the auditory system, but ignored the effect of temporal characteristics of noise, and underestimated the degree of hearing loss associated with complex noise. This paper first introduced the limitations of current noise exposure assessment standards at home and abroad, then introduced the definition of temporal kurtosis and the calculation method of its related energy indexes(such as cumulative noise exposure and equivalent continuous A-weighted sound pressure level), and further summarized the effectiveness of temporal kurtosis as an auxiliary parameter of noise energy in assessing the risk of hearing loss caused by complex noise, providing a rationale to supplement the existing noise assessment standards.