妊娠期糖尿病孕早期预测因素的临床研究  

Clinical Study on Predictors of Gestational Diabetes Mellitus during Early Pregnancy

作　　者：刘亚[1] 黄韵[2] 胡吉[2] 许国华 郁秋荣[1] LIU Ya;HUANG Yun;HU Ji;XU Guohua;YU Qiurong(Department of Endocrinology,Changshu No.2 People′s Hospital,Changshu 215500,China;Department of Endocrinology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Changshu Medicine Examination Institute,Changshu 215500,China)

机构地区：[1]常熟市第二人民医院内分泌科,江苏常熟215500 [2]苏州大学附属第二医院内分泌科,江苏苏州215004 [3]常熟市医学检验所,江苏常熟215500

出　　处：《医学综述》2018年第6期1239-1243,共5页Medical Recapitulate

摘　　要：目的分析孕早期预测妊娠期糖尿病(GDM)发病的危险因素。方法选择2015年9月至2016年3月在常熟市第二人民医院围生期门诊定期产检的孕妇共290例,孕10~14周测空腹血糖(FPG),孕24~28周行GDM筛查,根据是否患有GDM分为GDM组和正常糖耐量(NGT)组,计算GDM的发生率,比较两组孕妇的妊娠年龄、孕早期体质指数、孕早期FPG、生育史、家族史等,探讨GDM孕早期的预测因素。结果 GDM发生率为16.90%(49/290)。多因素Logistic回归分析结果显示,孕早期FPG是GDM的独立危险因素(P<0.001,95%CI 5.242~40.887);受试者工作特征曲线分析结果显示孕早期FPG预测GDM的曲线下面积为0.775,灵敏度为0.694,特异度为0.772。结论孕早期FPG是GDM发生的独立危险因素,孕早期FPG≥5.115 mmol/L的孕妇GDM发生风险明显增加。Objective To explore the risk factors of gestational diabetes mellitus(GDM)during early pregnancy.Methods A total of 290 pregnant women who received antenatal examination in Changshu No.2 People′s Hospital during Sep.2015 and Mar.2016 were included in the study.Fasting plasma glucose(FPG)were measured at 10-14 weeks′gestation,and GDM screening was carried out at 24-28 weeks′gestation.The GDM group and the normal glucose tolerance(NGT)group were classified according to GDM.The incidence of GDM was calculated,and the data of gestational age,early pregnancy body mass index and FPG,reproductive history,family history of the two groups were compared.We also analyzed the difference between GDM and NGT groups to explore the predictors of GDM during early pregnancy.Results The prevalence of GDM in this study was 16.90%(49/290).The multiple-factor Logistic regression analysis showed that early pregnancy FPG was an independent risk factor of GDM(P<0.001,95%CI 5.242-40.887).Receiver operator characteristic curve analysis instructed that area under curve of early pregnancy FPG predicting GDM was 0.775,the sensitivity was 0.694,and the specificity was 0.772.Conclusion Early pregnancy FPG is an independent risk factor of GDM.Pregnant women at early pregnancy with FPG≥5.115 mmol/L have significant higher risk of GDM.

关 键 词：妊娠期糖尿病 孕早期 空腹血糖 预测因素 

分 类 号：R589.1[医药卫生—内分泌]