Shi Chun-yan, Yang Hui-xia, Dong Yue, Xie Cui-ying, Zhang Yin-hua, Gao Li-li, Qin Xiao-qi
Department of Gynecology and Obstetrics of First Hospital, Beijing University, Beijing 100034, China.
Zhonghua Fu Chan Ke Za Zhi. 2003 Mar;38(3):136-9.
To study the cutoff value, the appropriate time of the 50 g oral glucose challenge test (GCT) to screen the gestational diabetes mellitus (GDM) and to study the importance of the maternal age and body weight of GDM.
The clinical data of 8 665 pregnant women who underwent the GCT from January 1995 to March 2001 in the Department of Obstetrics and Gynecology of the First Hospital of Beijing University were collected, and a retrospective study was made.
(1) The 1 h average plasma glucose level of the GCT is (6.8 +/- 1.7) mmol/L. The abnormal rate of GCT was 25.2% using 7.8 mmol/L as the cutoff, 5.3% (17/321) of GDM were misdiagnosed. When the cutoff is 7.2 mmol/L, the abnormal rate is increased to 36.5%, and 2.8% (9/321) of GDM were more diagnosed. If a value of 8.3 mmol/L as threshold, there would be 15.9% (51/321) of GDM to misdiagnose. (2) When 1 h blood glucose is >or= 11.2 mmol/L, the incidence of GDM is 55.8% (92/165). Among them, 62.0% (57/92) GDM could be diagnosed according to the fasting blood glucose. (3) There were no difference in the rate of abnormal GCT when GCT underwent between 24 and 36 weeks of gestation. (4) The rate of abnormal GCT and the incidence of the GDM are obviously different among the different age groups. The incidence of GDM among the women younger than 25 years old without high risk factors is only 0.3%, obviously lower than the other groups. (5) The average body mass index (BMI) of the women between 26 to 28 weeks of gestation is (24.9 +/- 2.9) kg/m(2). When the BMI is >or= 27.8 (x +/- s), the rate of abnormal GCT and the incidence of the GDM were obviously higher than the other women.
(1) 7.8 mmol/L as the cutoff of the GCT for the screening of GDM is appropriate. When the 1 h blood glucose level is >or= 11.2 mmol/L, fasting blood glucose should first be done to diagnose GDM. (2) It is necessary to screen GDM as soon as possible after 24 weeks of gestation, but for the women with obviously high risk factors GCT should be done before 24 weeks of gestation. (3) Age and obesity are the important risk factors for the GDM. It is not necessary to screen GDM among the pregnant women younger than 25 years old without high risk factors.
研究50g口服葡萄糖耐量试验（GCT）筛查妊娠期糖尿病（GDM）的切点值、适宜时间，并探讨孕妇年龄及体重在GDM中的重要性。
收集1995年1月至2001年3月北京大学第一医院妇产科行GCT的8665例孕妇的临床资料，进行回顾性研究。
（1）GCT 1小时平均血糖水平为（6.8±1.7）mmol/L。以7.8mmol/L为切点，GCT异常率为25.2%，漏诊GDM 5.3%（17/321）。当切点为7.2mmol/L时，异常率增至36.5%，误诊GDM 2.8%（9/321）。若以8.3mmol/L为切点，将漏诊GDM 15.9%（51/321）。（2）当1小时血糖≥11.2mmol/L时，GDM发生率为55.8%（92/165）。其中，62.0%（57/92）的GDM可根据空腹血糖诊断。（3）妊娠24至36周进行GCT，GCT异常率无差异。（4）不同年龄组GCT异常率及GDM发生率差异明显。无高危因素的25岁以下孕妇GDM发生率仅0.3%，明显低于其他组。（5）妊娠26至28周孕妇平均体重指数（BMI）为（24.9±2.9）kg/m²。当BMI≥27.8（x±s）时，GCT异常率及GDM发生率明显高于其他孕妇。
（1）以7.8mmol/L作为GCT筛查GDM的切点合适。当1小时血糖水平≥11.2mmol/L时，应先查空腹血糖以诊断GDM。（2）妊娠24周后应尽早筛查GDM，但高危因素明显者应在妊娠24周前进行GCT。（3）年龄及肥胖是GDM的重要危险因素。无高危因素的25岁以下孕妇无需筛查GDM。
