孕早期(8-14周)空腹血浆葡萄糖、体质指数、糖化血红蛋白以及血脂对妊娠期糖尿病预测的临床意义  

The Clinical Significance of Fasting Plasma Glucose,Body Mass Index,Glycosylated Hemoglobin and Blood Fat of Early Pregnancy(8-14 Weeks) in Predicting Gestational Diabetes Mellitus

作　　者：费晓萍 祝亚平[2] 沈建芳 刘丽 王琴 李晨波 李文娟 FEI Xiao-ping;ZHU Ya-ping;SHEN Jian-fang(The First People＇s Hospital of Kunshan,Kunshan 215300,China;Shanghai First People＇s Hospital,Shanghai 200000,China)

机构地区：[1]昆山市第一人民医院妇产科,江苏昆山215300 [2]上海市第一人民医院妇产科,上海200000

出　　处：《中国实验诊断学》2018年第11期1931-1934,共4页Chinese Journal of Laboratory Diagnosis

基　　金：江苏大学医学临床科技发展基金项目资助(项目编号JLY20160055)

摘　　要：目的探讨孕早期空腹血浆葡萄糖(FPG)、体质指数(BMI)、糖化血红蛋白(HbA1c)以及血脂等指标在妊娠期糖尿病(GDM)预测中的临床意义。方法选取昆山市第一人民医院建卡产检并确诊GDM孕妇78例和同期建卡产检的正常孕妇75例,分别测定孕早期FPG、BMI、HbA1c及血脂等数据进行比较。结果 GDM组孕妇孕早期(8-14周)FPG、BMI、HbA1c、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、载脂蛋白B(ApoB)均高于正常组,高密度脂蛋白(HDL)低于正常组,两组相比,差异有统计学意义(P<0.05)。受试者工作曲线(ROC曲线)分析其曲线下面积HbA1c0.729(95%的CI 0.650-0.808),P=0.000,具有临床预测价值。FPG 0.672(95%的CI 0.587-0.757),P=0.000;BMI 0.609,(95%的CI 0.520-0.698),P=0.020;TG 0.672,(95%的CI 0.586-0.757),P=0.000;LDL 0.623,(95%的CI 0.535-0.711),P=0.009;ApoB 0.670,(95%的CI 0.585-0.754),P=0.000;其预测能力大小分别是HbA1c>FPG=TG>ApoB>LDL>BMI。结论孕早期FPG、BMI、HbA1c及血脂等指标与GDM的发生密切相关,其对GDM的预测有一定的价值,及早认识及进行干预有重要意义。Objective To investigate the association of fasting plasma glucose（FPG）,body mass index（BMI）,glycosylated hemoglobin（HbAlc）and blood fat in early pregnancy（8-14 Weeks）with risk of gestational diabetes mellitus（GDM）.Methods We selected 78 diagnosed cases of GDM pregnant women at The First People＇s Hospital of Kunshan,and 75 normal pregnant women from the same period as the control group.The data of FPG,BMI,HbAlc and blood fat in early pregnancy（8-14 weeks of gestation）was measured and compared.Results The FPG,BMI,HbAlc,Total Cholesterol（TC）,Triglyceride（TG）,Low Density Lipoprotein（LDL）and Apolipoprotein B（ApoB）in the GDM group were significantly higher than the control group,while High Density Lipoprotein（HDL）was significantly lower in the GDM group（P〈0.05）.We performed receiver operating characteristics（ROC）curve analysis for the utility of HbA1 cas a prediction criteria of GDM,and the area under the curve was 0.729（95%confidence interval（CI）,0.650 to 0.808）,P=0.000,showing clinical significance.The area under the ROC curve for FPG was 0.672（95% CI,0.587-0.757,P=0.000）,BMI was 0.609（95%CI,0.520-0.698,P=0.020）,TG was 0.672（95% CI,0.586-0.757,P=0.000）,LDL was 0.623（95% CI,0.535-0.711,P=0.009）,ApoB was 0.670（95% CI,0.585-0.754,P=0.000）.The ability to predict GDM in early pregnancy was HbA1c〉FPG=TG〉ApoB〉LDL〉BMI.Conclusion Our results suggest that the risk of developing GDM has close association with FPG,BMI,HbAlc and blood fat in early pregnancy,and the clinical value of these data will provide valuable information for early diagnosis and intervention of GDM.

关 键 词：妊娠期糖尿病 空腹血浆葡萄糖 体质指数 糖化血红蛋白 血脂 

分 类 号：R446.1[医药卫生—诊断学]