上海朱泾地区妊娠早期空腹血糖与妊娠期糖尿病相关性的回顾性分析  

A retrospective analysis of relationship between fasting plasma glucose in early pregnancy and the prevalence of gestational diabetes mellitus in Shanghai Zhujing suburbs

作　　者：田海荣[1] 季业[1] 甘桂萍 余意 董晓娟 沈英娣[1] 刘波[1] 刘芳[3] TIAN Hai-rong JI Ye GAN Gui-ping et al(Department of Endocrinology ＆ Metabolism, Jin Shan Branch of Shanghai Sixth Peoples＇ Hospital, Shanghai 201599, China)

机构地区：[1]上海市第六人民医院金山分院内分泌代谢科,201599 [2]上海市第六人民医院金山分院妇产科,201599 [3]上海交通大学附属第六人民医院内分泌代谢科

出　　处：《中国糖尿病杂志》2017年第4期303-307,共5页Chinese Journal of Diabetes

基　　金：上海市医学和农业领域科技支撑项目(15411953100)

摘　　要：目的探讨妊娠早期FPG对GDM的预测价值。方法回顾性分析2014年于上海市第六人民医院金山分院产检和住院孕妇妊娠早期FPG水平,以及妊娠24~28周75 g OGTT资料;根据妊娠早期FPG水平对行OGTT的孕妇进行四分位分组,比较并分析妊娠早期FPG与OGTT不同时点血糖及GDM关系。结果 2165名孕妇中GDM 248例;GDM组妊娠早期FPG水平高于非GDM组[(4.86±0.48)vs(4.67±0.32)mmol/L,P<0.01];仅用FPG诊断GDM患病率四分位组比较,差异有统计学意义(P<0.01),仅用1 hPG或2 hPG诊断GDM患病率四分位组比较,差异无统计学意义(P>0.05)。相关分析显示,妊娠早期FPG与妊娠中期FPG呈正相关(r=0.497,P<0.01)。妊娠早期FPG预测仅用FPG诊断的GDM受试者工作特征(ROC)曲线下最大面积(AUC)为0.834(95%CI:0.796~0.871,P<0.01),切点为5.05 mmol/L,敏感性66.7%,特异性88.4%。结论上海朱泾地区孕妇GDM患病率为11.45%;仅以妊娠早期FPG预测GDM能力较低。Objective To study whether the fasting plasma glucose （FPG） in early pregnancy can predict the risk o{ gestational diabetes mellitus （GDM）. Methods Totally 2165 pregnant women with plasma glucose first detected in the first trimester of pregnancy were enrolled. 75 g oral glucose tolerance test （OGTT） were performed at 24-28 week. The relationship between FPG in early pregnancy and OGTT plasma glucose at different time points and the prevalence of GDM were analyzed. Results 248 were identified as GDM in 2,165 pregnant women. FPG in early pregnancy of GDM group was higher than non- GDM group [（4.86±0.48） vs （4. 67±0.32） mmol/L,P〈0. 01]. Tt{e incidence of GDM diagnosed only by FPG quartiles had significant differences （10/45,8/40,24/55,73/108, P〈0.01）. The incidence of GDM diagnosed only by OGTT 1 h or by （TT 2 h quartiles had no significant differences（P〉0.05）. FPG in early pregnancy was positively associated with OGTT FPG （r= 0. 497, P〈0.01）, but not with OGTT 1 hPG or 2 hPG （r=- 0. 086,-0. 087, P〉0. 05）. The area under receiver operating characteristic curve for FPG to predict GDM was 0. 834 （95% CI： 0. 796-0. 871, P〈0.01）, with the optimal cut-off FPG 5.05 retool/L, the sensitivity 52.4% and the specificity 74.8%, respectively. Conclusion The prevalence of GDM is 11.45% in Shanghai Zhujing suburbs. The capability to predict GDM merely with FPG in early pregnancy is low.

关 键 词：空腹血糖 糖尿病 妊娠 流行病学 预测 

分 类 号：R714.256[医药卫生—妇产科学]