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本文引用的文献

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International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy.国际糖尿病与妊娠研究组协会关于妊娠期间高血糖的诊断和分类的建议
Diabetes Care. 2010 Mar;33(3):676-82. doi: 10.2337/dc09-1848.
2
Diagnosis and classification of diabetes mellitus.糖尿病的诊断与分类
Diabetes Care. 2010 Jan;33 Suppl 1(Suppl 1):S62-9. doi: 10.2337/dc10-S062.
3
Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population.妊娠期糖尿病：在多民族高危人群中应用空腹毛细血管血糖筛查
Diabet Med. 2009 Aug;26(8):760-5. doi: 10.1111/j.1464-5491.2009.02765.x.
4
Gestational diabetes: using a portable glucometer to simplify the approach to screening.妊娠期糖尿病：使用便携式血糖仪简化筛查方法。
Gynecol Obstet Invest. 2008;66(3):178-83. doi: 10.1159/000140602. Epub 2008 Jun 19.
5
Gestational diabetes: utility of fasting plasma glucose as a screening test depends on the diagnostic criteria.妊娠期糖尿病：空腹血糖作为筛查试验的效用取决于诊断标准。
Diabet Med. 2006 Dec;23(12):1319-26. doi: 10.1111/j.1464-5491.2006.01987.x.
6
Gestational diabetes: dilemma caused by multiple international diagnostic criteria.妊娠期糖尿病：多种国际诊断标准引发的困境
Diabet Med. 2005 Dec;22(12):1731-6. doi: 10.1111/j.1464-5491.2005.01706.x.
7
Gestational diabetes in a high-risk population: using the fasting plasma glucose to simplify the diagnostic algorithm.高危人群中的妊娠期糖尿病：利用空腹血糖简化诊断算法。
Eur J Obstet Gynecol Reprod Biol. 2005 May 1;120(1):39-44. doi: 10.1016/j.ejogrb.2004.07.034.
8
Achieving standardization in clinical research: changing cacophony into harmony.实现临床研究的标准化：变嘈杂为和谐。
Ann Emerg Med. 2004 Sep;44(3):213-4. doi: 10.1016/j.annemergmed.2004.03.032.
9
Population health significance of gestational diabetes.妊娠期糖尿病对人群健康的意义。
Diabetes Care. 2003 Jul;26(7):2005-9. doi: 10.2337/diacare.26.7.2005.
10
Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.糖尿病诊断与管理中实验室分析的指南与建议。
Clin Chem. 2002 Mar;48(3):436-72.

妊娠期糖尿病：使用空腹血糖简化国际糖尿病与妊娠研究组诊断算法。

Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose.

机构信息

Department of Pathology, Faculty of Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.

出版信息

Diabetes Care. 2010 Sep;33(9):2018-20. doi: 10.2337/dc10-0572. Epub 2010 Jun 2.

DOI:10.2337/dc10-0572
PMID:20519664
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2928355/
Abstract

OBJECTIVE

To determine the impact of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria on 1) gestational diabetes mellitus (GDM) diagnosis compared with the American Diabetes Association (ADA) criteria and 2) the fasting plasma glucose (FPG) to predict GDM.

RESEARCH DESIGN AND METHODS

In 10,283 pregnant women undergoing a 75-g oral glucose tolerance test (OGTT) for universal screening of GDM, two FPG thresholds (of the OGTT) were used to rule in and to rule out GDM.

RESULTS

The IADPSG and ADA criteria identified GDM in 3,875 (37.7%) women and 1,328 (12.9%) women, respectively (P < 0.0005). FPG thresholds of >or=5.1 mmol/l ruled in GDM in 2,975 (28.9%) women with 100% specificity, while <4.4 mmol/l ruled out GDM in 2,228 (21.7%) women with 95.4% sensitivity. FPG independently could have avoided the OGTT in 5,203 (50.6%) women.

CONCLUSIONS

The IADPSG criteria increased GDM prevalence nearly threefold. By circumventing a significant number of OGTTs, an initial FPG can greatly simplify the IADPSG diagnostic algorithm.

摘要

目的

确定国际妊娠合并糖尿病研究组织（IADPSG）标准对以下方面的影响：1）与美国糖尿病协会（ADA）标准相比，对妊娠期糖尿病（GDM）的诊断；2）空腹血糖（FPG）对 GDM 的预测。

研究设计和方法

在 10283 名接受 75g 口服葡萄糖耐量试验（OGTT）以进行 GDM 普遍筛查的孕妇中，使用两种 FPG 阈值（OGTT 中的）来确定 GDM 的确诊和排除。

结果

IADPSG 和 ADA 标准分别在 3875 名（37.7%）和 1328 名（12.9%）女性中诊断出 GDM（P<0.0005）。FPG 阈值>或=5.1mmol/L 可确诊 2975 名（28.9%）女性的 GDM，特异性为 100%，而<4.4mmol/L 可排除 2228 名（21.7%）女性的 GDM，敏感性为 95.4%。FPG 可独立避免 5203 名（50.6%）女性进行 OGTT。

结论

IADPSG 标准使 GDM 的患病率增加了近三倍。通过规避大量的 OGTT，初始 FPG 可以极大地简化 IADPSG 的诊断算法。