Wei Yu-Mei, Yang Hui-Xia, Gao Xue-Lian
Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
Zhonghua Fu Chan Ke Za Zhi. 2008 Sep;43(9):647-50.
To investigate the incidence of glucose metabolism disorder during pregnancy and establish the diagnosis criteria for gestational diabetes mellitus (GDM) among Chinese patients.
A prospective population-based study of 16 286 pregnant women, who received 50 g glucose challenge test (GCT) for the first time between Apr 1, 2006 and Sept 30, 2006, was performed throughout 18 cities in China.
According to national diabetes data group (NDDG) criteria, the overall incidence of GDM and glucose impaired glucose tolerance (GIGT) was 2.763% (450/16 286) and 3.862% (629/16 286), respectively; it changed to 5.078% (827/16 286) and 5.268% (858/16 286) when using American diabetes association (ADA) criteria. If the women who had 2 or more abnormal oral glucose tolerance test (OGTT) values meeting or exceeding ADA criteria was classified as group 1, and the women who had one or more meeting or exceeding NDDG criteria was group 2, the ratio of women who met both the criteria of ADA and NDDG in group 1 was 94.2%. The 95%CI of normal glucose when using ADA criteria were fasting glucose 5.3 mmol/L, 1 hour 10.4 mmol/L, 2 hour 8.7 mmol/L, 3 hour 7.7 mmol/L, which is close to ADA criteria.
ADA criterion is more suitable for Chinese patients. According to NDDG criteria, it is reasonable to treat the patient with 1 or more abnormal OGTT values, and if choosing ADA criteria, 2 or more abnormal OGTT values is more reasonable.
调查孕期糖代谢紊乱的发生率,并建立中国患者妊娠期糖尿病(GDM)的诊断标准。
对2006年4月1日至2006年9月30日期间首次接受50克葡萄糖耐量试验(GCT)的16286名孕妇进行了一项基于人群的前瞻性研究,该研究在中国18个城市开展。
根据美国国家糖尿病数据组(NDDG)标准,GDM和糖耐量受损(GIGT)的总体发生率分别为2.763%(450/16286)和3.862%(629/16286);采用美国糖尿病协会(ADA)标准时,发生率分别变为5.078%(827/16286)和5.268%(858/16286)。若将口服葡萄糖耐量试验(OGTT)有2个或更多异常值且达到或超过ADA标准的女性归为第1组,将有1个或更多异常值且达到或超过NDDG标准的女性归为第2组,则第1组中同时符合ADA和NDDG标准的女性比例为94.2%。采用ADA标准时正常血糖的95%可信区间为空腹血糖5.3毫摩尔/升、1小时10.4毫摩尔/升、2小时8.7毫摩尔/升、3小时7.7毫摩尔/升,这与ADA标准相近。
ADA标准更适合中国患者。根据NDDG标准,对OGTT有1个或更多异常值的患者进行治疗是合理的;若选择ADA标准,OGTT有2个或更多异常值则更合理。