Lind T, Phillips P R
MRC Human Reproductive Group, Princess Mary Maternity Hospital, Newcastle upon Tyne, United Kingdom.
Diabetes. 1991 Dec;40 Suppl 2:8-13. doi: 10.2337/diab.40.2.s8.
This study reports the responses to a 75-g oral glucose tolerance test (OGTT) in 1009 pregnant women from throughout Europe. We reached the following conclusions. 1) A pregnant woman tends to have blood glucose concentrations that are elevated for a longer period of time after an oral glucose load. Therefore, approximately 10% of women will reach or exceed 8 mM glucose at 2 h, but it is unlikely that 10% of European women have disordered carbohydrate metabolism. 2) The fasting and 1-h values should be included in any analysis of the response of the patient. By doing this, many fewer women will have responses regarded as abnormal; in this series, it reduced the 79 women with a 2-h value greater than 8 mM to 15 who were considered to have carbohydrate intolerance (2 with diabetes, 13 with impaired glucose tolerance [IGT]). 3) By increasing the 2-h cutoff value to greater than or equal to 9 mM, the number of women regarded as at risk would be reduced by greater than 50% (from 79 to 32 in this series), but 10 of the 13 women with two abnormal values would still have been detected, as would the 2 diabetic women. 4) From the obstetric viewpoint, mothers who screen positive do not have bigger babies, they deliver close to term, and they do not have particular stigmas such as a family history of diabetes or an increased tendency to smoke or to have an adverse obstetric outcome. However, they do tend to be older and heavier.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究报告了来自欧洲各地的1009名孕妇对75克口服葡萄糖耐量试验(OGTT)的反应。我们得出了以下结论。1)孕妇口服葡萄糖负荷后血糖浓度往往会在较长时间内升高。因此,约10%的女性在2小时时血糖会达到或超过8 mM,但欧洲不太可能有10%的女性存在碳水化合物代谢紊乱。2)在对患者反应的任何分析中都应纳入空腹值和1小时值。这样做的话,被视为异常反应的女性会少得多;在本系列研究中,将2小时值大于8 mM的79名女性减少到了15名被认为有碳水化合物不耐受的女性(2名糖尿病患者,13名糖耐量受损[IGT]患者)。3)将2小时临界值提高到大于或等于9 mM,被视为有风险的女性数量将减少超过50%(本系列中从79名减至32名),但13名有两个异常值的女性中的10名仍会被检测出来,2名糖尿病女性也会被检测出来。4)从产科角度来看,筛查呈阳性的母亲所生婴儿并不更大,她们接近足月分娩,也没有诸如糖尿病家族史、吸烟倾向增加或产科不良结局等特殊问题。然而,她们往往年龄更大、体重更重。(摘要截选至250字)