孕10-14周临床危险因素预测妊娠期糖尿病发生的模型构建  

Modeling of Clinical Risk Factors for Gestational Diabetes Mellitus at 10 to 14 Weeks of Gestation

作　　者：魏敬艳 史少文 WEI Jingyan;SHI Shaowen(Obstetrics Department,Qinhuangdao First Hospital,Qinhuangdao,Hebei,066000,China)

机构地区：[1]秦皇岛市第一医院产科,河北秦皇岛066000

出　　处：《中国社会医学杂志》2023年第3期369-372,共4页Chinese Journal of Social Medicine

基　　金：河北医学科学课题计划(20221608);秦皇岛市科学技术研究与发展计划项目(202004A121)。

摘　　要：目的探讨孕10~14周临床危险因素预测妊娠期糖尿病发生的模型构建。方法回顾性分析2015年1月-2018年12月于某院住院分娩的1508名孕妇的临床资料。根据口服葡萄糖耐量试验将孕妇分为妊娠期糖尿病组与对照组,比较两组孕妇临床资料,运用Logistic回归分析探讨孕10~14周妊娠期糖尿病的危险因素,通过绘制受试者工作特征曲线(ROC)分析曲线下面积(AUC)。结果1508例孕妇中经口服葡萄糖耐量试验检测,其中妊娠期糖尿病266例。两组孕妇年龄、孕前BMI、孕次、合并糖尿病家族史、γ-谷氨酰转移酶(GGT)、红细胞(RBC)、血小板计数(PLT)、白细胞(WBC)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、空腹血糖(FPG)、血红蛋白(Hb)比较差异具有统计学意义(P<0.05)。多因素Logistics回归分析结果显示,WBC(OR=2.34,95%CI:1.11~4.93)、TG(OR=3.51,95%CI:2.01~6.14)、FPG(OR=3.08,95%CI:1.25~7.61)、年龄(OR=4.36,95%CI:1.01~19.20)、孕前BMI(OR=2.53,95%CI:1.64~10.48)是妊娠期糖尿病的危险因素(P<0.05)。通过ROC曲线将上述危险因素进行分析,结果显示,联合检测模型预测妊娠期糖尿病发生风险的AUC为0.811(95%CI:0.77~0.84),截断值为0.57,特异度与敏感度分别为79.03%与66.81%。结论孕妇年龄、BMI、WBC、FPG及TG均为妊娠期糖尿病患者的危险因素,将这些影响因素联合可预测妊娠期糖尿病的发生可能性。Objective To explore the model construction of clinical risk factors for predicting gestational diabetes mellitus at 10 to 14 weeks of gestation.Methods The clinical data of 1508 pregnant women who delivered in our hospital from January 2015 to December 2018 were retrospectively analyzed.According to oral glucose tolerance test,pregnant women were divided into gestational diabetes mellitus group and control group.The clinical data of pregnant women in the two groups were compared.The risk factors of gestational diabetes mellitus at 10-14 weeks of gestation were analyzed by Logistic regression analysis.Results Among 1508 pregnant women,266 cases(17.64%)were complicated with gestational diabetes mellitus.The differences in Age,BMI before pregnancy,gestational times,family history of diabetes,GGT,RBC,PLT,WBC,TG,TC,HDL-C,LDL-C,fasting blood glucose(FPG),HbA1 C and Hb were statistically significant(P<0.05).The results of multi-factor logistics regression model showed that WBC(OR=2.34,95%CI:1.11-4.93),TG(OR=3.51,95%CI:2.01-6.14),FPG(OR=3.08,95%CI:1.25-7.61),age(OR=4.36,95%CI:1.01-19.20)and BMI before pregnancy(OR=2.53,95%CI:1.64-10.48)were risk factors for gestational diabetes mellitus(P<0.05).ROC curve was used to analyze the above risk factors.The results showed that the AUC of the combined detection model for predicting the risk of gestational diabetes mellitus was 0.811(95%CI:0.77-0.84),the cut-off value was 0.57,and the specificity and sensitivity were 79.03%and 66.81%,respectively.Conclusion Maternal age,BMI,WBC,FPG and TG were all risk factors for gestational diabetes mellitus and these factors could be combined to predict the possibility of gestational diabetes mellitus.

关 键 词：妊娠期 糖尿病 血糖 血脂 预测 危险因素 

分 类 号：R587.1[医药卫生—内分泌] R715.3[医药卫生—内科学]