甲状腺激素、HbA1c、HOMA-IR诊断妊娠期糖尿病价值  

Diagnostic values of the levels of thyroxine antibody,glycosylated hemoglobin,and the values of homeostasis model assess ment of insulin resistance for gestational diabetes mellitus

作　　者：刘成坤 马开树 付林 LIU Chengkun;MA Kaishu;FU Lin(Funan County People's Hospital,Fuyang Province,236300;The Second Affiliated Hospital of Anhui Medical University)

机构地区：[1]安徽省阜南县人民医院,236300 [2]安徽医科大学第二附属医院

出　　处：《中国计划生育学杂志》2023年第3期716-719,共4页Chinese Journal of Family Planning

摘　　要：目的:分析甲状腺激素、甲状腺过氧化物酶抗体(TPOAb)、血清糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)诊断妊娠期糖尿病(GDM)效能。方法:选取2019年1月-2022年6月本院就诊孕妇131例,按GDM诊断标准分成GDM组(n=72)及对照组(n=59),观察两组血清甲状腺激素相关指标、HbA1c、HOMA-IR水平,分别各指标诊断GDM的效能,观察两组不良妊娠结局发生情况。结果:GDM组游离型四碘甲状腺原氨酸(FT4)水平(9.45±2.02 pmol/L)低于对照组(10.63±2.35 pmol/L),血清HbA1c[(5.82±1.51)%、HOMA-IR(2.47±0.52)]水平均高于对照组[(4.26±1.24)%、1.55±0.61)](均P<0.001);受试者工作特征曲线分析,3项指标联合检测的曲线下面积(0.931)高于FT4(0.746)、HbA1c(0.789)、HOMA-IR(0.652)单项检测,敏感度82.0%、特异度88.0%;不良妊娠结局发生GDM组(37.5%)高于对照组(13.6%)(P<0.05)。结论:血清FT4、HbA1c、HOMA-IR联合检测对诊断GDM有较高效能,可为孕期干预提供参考。Objective:To analyze the diagnostic efficacy the levels of thyroxine antibody(TPOAb),glycosylated hemo-globin(HbA1c),and the value of homeostasis model assessment of insulin resistance(HOMA-IR)for gestational diabetes mellitus(GDM).Methods:A total of 131 pregnant women were selected and were divided into group A(72 women with GDM)and group B(59 women without GDM)according to the gold standard results of diagnosing GDM from January 2019 to June 2022.The serum thyroid hormone related indicators,the HbA1c level,and the HOMA-IR value of the women in the two groups were observed,and the efficacy of which for diagnosing GDM was analyzed.The incidences of adverse pregnancy outcomes of the women in the two groups were observed.Results:The level of free tetriodothyronine(FT4)of the women(9.45±2.02 pmol/L)in group A was significantly lower than that(10.63±2.35 pmol/L)of the women in group B.The serum HbA1c level[(5.82±1.51)%],and the HOMA-IR value(2.47±0.52)of the women in group A were significantly higher than those[(4.26±1.24)%.1.55±0.61)]of the women in group B(all P<0.001).The receiver operator characteristic curve analysis had showed that the area under the curve(0.931)of the combined detections of the levels of serum HbA1c and FT4,and the HOMA-IR value of the women for diagnosing their GDM was higher than that of the FT4 level(0.746),the HbA1c level(0.789),or the HOMA-IR value(0.652)alone.The sensitivity and the specificity of the combined detections of the levels of serum HbAlc and FT4,and the HOMA-IR value of the women for diagnosing their GDM were 82.0%and 88.0%.The rate of adverse pregnancy out-comes(37.5%)of the women in group A was significantly higher than that(13.6%)of the women in group B(P<0.05).Conclusion:The combined detections of the levels of serum HbA1c and FT4,and the HOMA-IR value of the women for diagnosing their GDM has high efficiency,and which can provide reference for early intervention of GDM.

关 键 词：妊娠期糖尿病 甲状腺激素 甲状腺过氧化物酶抗体 血清糖化血红蛋白 胰岛素抵抗指数 诊断价值 

分 类 号：R714.256[医药卫生—妇产科学]