Senanayake Hemantha, Seneviratne Sanjeewa, Ariyaratne Hemal, Wijeratne Sumeda
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Colombo, Sri Lanka.
J Obstet Gynaecol Res. 2006 Jun;32(3):286-91. doi: 10.1111/j.1447-0756.2006.00400.x.
To compare fasting plasma glucose (FPG) against 2-h postprandial plasma glucose (PPPG), following a carbohydrate meal, for screening of gestational diabetes mellitus (GDM) in southern Asian women with one or more risk factors.
A comparative study was conducted at a university obstetric unit in Sri Lanka. Two hundred and seventy one women undergoing oral glucose tolerance test (OGTT) according to the WHO criteria of 1999 had a 2-h PPPG performed within the following week. Sensitivity, specificity, predictive values and correlation coefficients for predicting a diagnosis of GDM and areas under receiver-operator curves (ROC) were calculated for FPG and PPPG. The ability to predict GDM and to reduce the need for OGTT were the main outcome measures.
The mean period of gestation was 26.43 weeks (SD = 5.4) Seventy-five (27.7%) women were diagnosed with GDM. The optimal threshold for FPG was 4.4 mmol/L and for PPPG 4.7 mmol/L. At these, sensitivity was 92.0% and 90.7%, specificity 48.7% and 25.4% and the areas under the ROC 0.82 and 0.73 for FPG and PPPG, respectively. Nine (12%) women could be diagnosed as having GDM on the basis of the FPG being above the threshold.
FPG is superior to 2-h PPPG for screening high-risk women for GDM. Nine women were diagnosed as having GDM on the basis of having an FPG above 7 mmol/L. FPG could reduce the number of OGTT needed by 40.9%, compared to 20.6% by PPPG. FPG is a less cumbersome and cost-effective screening test.
比较在一餐碳水化合物餐后的空腹血糖（FPG）与餐后2小时血糖（PPPG），用于筛查有一个或多个危险因素的南亚女性妊娠期糖尿病（GDM）。
在斯里兰卡一所大学的产科单位进行了一项对比研究。根据1999年世界卫生组织标准接受口服葡萄糖耐量试验（OGTT）的271名女性在接下来的一周内进行了餐后2小时血糖检测。计算了FPG和PPPG预测GDM诊断的敏感性、特异性、预测值和相关系数以及受试者工作特征曲线（ROC）下的面积。预测GDM的能力和减少OGTT需求是主要的结局指标。
平均孕周为26.43周（标准差 = 5.4）。75名（27.7%）女性被诊断为GDM。FPG的最佳阈值为4.4 mmol/L，PPPG为4.7 mmol/L。在此阈值下，FPG的敏感性为92.0%，特异性为48.7%，ROC下面积为0.82；PPPG的敏感性为90.7%，特异性为25.4%，ROC下面积为0.73。9名（12%）女性基于FPG高于阈值可被诊断为患有GDM。
对于筛查GDM的高危女性，FPG优于餐后2小时PPPG。9名女性基于FPG高于7 mmol/L被诊断为患有GDM。与PPPG可减少20.6%的OGTT需求相比，FPG可将所需OGTT的数量减少40.9%。FPG是一种更简便且具成本效益的筛查试验。
