Olarinoye J K, Ohwovoriole A E, Ajayi G O
Department of Medicine, University of Ilorin, Ilorin, Kwara State, Nigeria.
West Afr J Med. 2004 Jul-Sep;23(3):198-201. doi: 10.4314/wajm.v23i3.28120.
To compare the diagnostic performances of 75g and 100g oral glucose tolerance tests in detecting Gestational Diabetes Mellitus in Nigerian pregnant women.
248 women in 3rd trimester attending antenatal clinic of the Lagos University Teaching Hospital, Lagos, between November 1997 and July 1999 were randomly subjected to standard oral glucose tolerance tests (OGTT). 110 had 100g OGTT while 138 had 75g OGTT. The plasma glucose response (PGR) was assessed and glucose tolerance status of each patient was determined using WHO (1985) criteria to interpret 75g OGTT and National Diabetes Data Group (NDDG) (1979) criteria for 100g OGTT. The PGR in the two study groups were compared. The prevalence rates of GDM using either of the two criteria were evaluated and compared. Incidences of foetal macrosomia in GDM cases diagnosed by either set of criteria were also compared.
The mean age of the study subjects was 30.7(+/-4.2) years while the BMI was 25.4(+/-4.9) kg/m2. The mean parity was 1.33. Traditional risk factors for GDM were found in 47.5% of them. The plasma glucose response (PGR) to 100g OGTT was found to be higher than that of 75g OGTT at 1 hour, 2hour and 3 hour sampling times but the difference was only significant at 3rd hour (p values = 0.68, 0.137, 0.007 respectively). The total area under the glucose response curve (AUC) for 75g OGTT was 345.1 (+/-49.5) AAU while for 100g OGTT, it was 363.4(+/-61.4) AAU. The difference was not statistically significant (p value >0.05). The prevalence rate of GDM diagnosed by 75g OGTT was 11.6% while that of 100g OGTT was 4.5 %. The difference was significant (p value = 0.04). The incidence rate of foetal macrosomia among GDM cases diagnosed by 100g OGTT was 66.7% as against 23.1% among those diagnosed by 75g OGTT. Statistical difference could not be determined because of the small number.
Plasma glucose response to OGTT among Nigerian pregnant women has little or no respect for the load of the glucose administered. 100g OGTT- based NDDG criteria was more stringent than 75g OGTT-based WHO criteria in identifying GDM. However it appears to be more specific for detecting the complications associated with the condition though it will require a larger study to validate this claim.
比较75克和100克口服葡萄糖耐量试验在检测尼日利亚孕妇妊娠期糖尿病中的诊断性能。
1997年11月至1999年7月期间，在拉各斯拉各斯大学教学医院产前诊所就诊的248名孕晚期妇女被随机进行标准口服葡萄糖耐量试验（OGTT）。110人进行100克OGTT，138人进行75克OGTT。评估血浆葡萄糖反应（PGR），并根据世界卫生组织（1985年）标准解释75克OGTT以及根据国家糖尿病数据组（NDDG）（1979年）标准解释100克OGTT来确定每位患者的葡萄糖耐量状态。比较两个研究组的PGR。评估并比较使用两种标准中任何一种诊断的妊娠期糖尿病患病率。还比较了由任何一组标准诊断出的妊娠期糖尿病病例中巨大儿的发生率。
研究对象的平均年龄为30.7（±4.2）岁，体重指数为25.4（±4.9）kg/m²。平均产次为1.33。其中47.5%存在妊娠期糖尿病的传统危险因素。发现在1小时、2小时和3小时采样时间，100克OGTT的血浆葡萄糖反应（PGR）高于75克OGTT，但差异仅在第3小时显著（p值分别为0.68、0.137、0.007）。75克OGTT的葡萄糖反应曲线下总面积（AUC）为345.1（±49.5）AAU，而100克OGTT为363.4（±61.4）AAU。差异无统计学意义（p值>0.05）。75克OGTT诊断的妊娠期糖尿病患病率为11.6%，而100克OGTT为4.5%。差异显著（p值=0.04）。100克OGTT诊断的妊娠期糖尿病病例中巨大儿的发生率为66.7%，而75克OGTT诊断的病例中为23.1%。由于数量较少，无法确定统计学差异。
尼日利亚孕妇对OGTT的血浆葡萄糖反应几乎不或根本不受所给予葡萄糖负荷的影响。基于100克OGTT的NDDG标准在识别妊娠期糖尿病方面比基于75克OGTT的世界卫生组织标准更严格。然而，尽管需要更大规模的研究来验证这一说法，但它似乎在检测与该疾病相关的并发症方面更具特异性。
