既往诊断为妊娠期糖尿病的女性产后糖耐量的重新分类
Post-partum reclassification of glucose tolerance in women previously diagnosed with gestational diabetes mellitus.
作者信息
Costa A, Carmona F, Martinez-Roman S, Quintó L, Levy I, Conget I
机构信息
Servei d'Endocrinologia i Diabetis, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Facultat de Medicina, Universitat de Barcelona, Spain.
出版信息
Diabet Med. 2000 Aug;17(8):595-8. doi: 10.1046/j.1464-5491.2000.00341.x.
AIMS
To re-evaluate post-partum screening; fasting plasma glucose (FPG) vs. oral glucose tolerance test (OGTT) in Caucasian women with previous gestational diabetes mellitus (GDM).
METHODS
Once breast-feeding had finished, an OGTT was performed in 120 women with previous GDM. They were classified according to World Health Organization (WHO) 1985 and American Diabetes Association (ADA) 1997 criteria. The kappa-statistic measure of agreement was used to compared both diagnostic categories. A receiver-operating characteristic (ROC) curve studied the FPG as a test to detect abnormal glucose tolerance.
RESULTS
Identical diabetes prevalence (2%) but quite different intermediate categories (12% impaired glucose tolerance vs. 3% impaired fasting glucose) were observed with both criteria. The kappa-statistic (scaled from 0 to 1) was 0.38 (fair agreement), P = 0.000. The ROC curve area of the FPG was 0.65.
CONCLUSIONS
FPG is an unsatisfactory method of evaluating the glucose tolerance of Caucasian women with previous GDM. OGTT may be a better test for such a purpose.
目的
重新评估产后筛查；对既往有妊娠期糖尿病（GDM）的白种女性进行空腹血糖（FPG）与口服葡萄糖耐量试验（OGTT）的比较。
方法
120名既往有GDM的女性在停止母乳喂养后进行了OGTT。根据世界卫生组织（WHO）1985年和美国糖尿病协会（ADA）1997年的标准对她们进行分类。使用一致性的kappa统计量来比较两种诊断类别。通过绘制受试者操作特征（ROC）曲线来研究FPG作为检测糖耐量异常的一项检测指标。
结果
两种标准下观察到相同的糖尿病患病率（2%），但中间类别差异较大（糖耐量受损为12%，空腹血糖受损为3%）。kappa统计量（范围从0到1）为0.38（一致性尚可），P = 0.000。FPG的ROC曲线面积为0.65。
结论
FPG用于评估既往有GDM的白种女性的糖耐量并不理想。OGTT可能是用于此目的的更好检测方法。
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