[924例妊娠期糖尿病患者的诊断与治疗标志物]

[Markers of diagnosis and treatment in 924 pregnancies with gestational diabetes mellitus].

作者信息

Detsch Josiane Cristine Melchioretto, Almeida Ana Cristina Ravazzani de, Bortolini Luis Gustavo Cambrussi, Nascimento Denis José, Oliveira Junior Fernando Cesar, Réa Rosângela Roginski

机构信息

Hospital de Clínicas, Universidade Federal do Paraná, Av. Agostinho Leão Junior 285, Curitiba, PR, Brazil.

出版信息

Arq Bras Endocrinol Metabol. 2011 Aug;55(6):389-98. doi: 10.1590/s0004-27302011000600005.

DOI:10.1590/s0004-27302011000600005

PMID:22011855

Abstract

OBJECTIVES

To evaluate the epidemiological profile and outcomes of women with gestational diabetes mellitus (GDM), determining risk factors for increased vigilance.

SUBJECTS AND METHODS

We studied 924 pregnancies in 916 patients between November 6, 2001 and September 21, 2009.

RESULTS

Risk factors were found in 95.1% of cases. The prevalence of maternal diabetes, paternal diabetes and diabetes in other family members was 24.3%, 9.4% and 24.7%, respectively. Predictive factors for insulin use were: screening fasting glucose (FG) ≥ 85, Oral Glucose Tolerance Test (OGTT) FG ≥ 95, 2h glucose after 75 g ≥ 200 mg/dL, previous GDM, obesity, HbA1c > 6%, and the association of risk factors including family history of diabetes mellitus and obesity or previous GDM, the last one the most relevant (p < 0,05).

CONCLUSIONS

Risk factors were very sensitive for GDM detection, and provision of family history strengthens its relationship with T2DM. Greater vigilance is recommended for patients with predictive factors for insulin requirement.

摘要

目的

评估妊娠期糖尿病（GDM）女性的流行病学特征及结局，确定需提高警惕的危险因素。

研究对象与方法

我们对2001年11月6日至2009年9月21日期间916例患者的924次妊娠进行了研究。

结果

95.1%的病例发现有危险因素。母亲患糖尿病、父亲患糖尿病以及其他家庭成员患糖尿病的患病率分别为24.3%、9.4%和24.7%。使用胰岛素的预测因素为：筛查空腹血糖（FG）≥85、口服葡萄糖耐量试验（OGTT）空腹血糖≥95、75克葡萄糖负荷后2小时血糖≥200毫克/分升、既往有妊娠期糖尿病、肥胖、糖化血红蛋白（HbA1c）>6%，以及包括糖尿病家族史与肥胖或既往有妊娠期糖尿病在内的危险因素组合，其中后者最为相关（p<0.05）。