血浆甘油三酯/高密度脂蛋白胆固醇比值的对数值可预测早孕期低危妊娠期糖尿病。
The plasma logarithm of the triglyceride/HDL-cholesterol ratio is a predictor of low risk gestational diabetes in early pregnancy.
机构信息
Department of Medical Pathology, Federal University of Parana, Curitiba, Parana, Brazil.
出版信息
Clin Chim Acta. 2013 Mar 15;418:1-4. doi: 10.1016/j.cca.2012.12.004. Epub 2012 Dec 20.
BACKGROUND
The plasma lipid profile changes atherogenically during normal pregnancy. Gestational diabetes mellitus (GDM) can exacerbate the changes in metabolism. The logarithm of the ratio triglycerides/HDL-cholesterol is an atherogenic index of the plasma (AIP) and can be used as a marker for plasma atherogenicity.
METHODS
Serum of 576 unrelated Euro-Brazilian pregnant women was collected and the subjects were classified as healthy pregnant women (control, n=288) and gestational diabetic patients (GDM, n=288) according to the ADA 2010 criteria. Both studied groups were sub classified in 4 gestational periods: (i) 12-23, (ii) 24-28, (iii) 29-32 and (iv) >32 weeks of gestation.
RESULTS
Except for the AIP, the other parameters showed low discrimination between control and GDM groups (ROC curves). When analyzed by ROC curves the AIP of subjects in the early period of gestation showed sensitivity and specificity of 82.6% and 83.4%, respectively, with a cut-off point of 0.099 (AUC 0.886, P<0.0001).
CONCLUSIONS
The AIP is a valuable index to identify pregnant women with low risk of gestational diabetes before 24 weeks of gestation.
背景
正常妊娠期间，血浆脂质谱会发生致动脉粥样硬化变化。妊娠糖尿病（GDM）可使代谢变化恶化。甘油三酯/高密度脂蛋白胆固醇的对数是血浆的致动脉粥样硬化指数（AIP），可用作血浆致动脉粥样硬化性的标志物。
方法
收集了 576 名无亲缘关系的欧洲裔巴西孕妇的血清，并根据 ADA 2010 标准将受试者分为健康孕妇（对照组，n=288）和妊娠糖尿病患者（GDM，n=288）。两个研究组都按 4 个妊娠时期进行分类：（i）12-23 周，（ii）24-28 周，（iii）29-32 周和（iv）>32 周。
结果
除 AIP 外，其他参数在对照组和 GDM 组之间的区分度较低（ROC 曲线）。通过 ROC 曲线分析，妊娠早期受试者的 AIP 的灵敏度和特异性分别为 82.6%和 83.4%，截断值为 0.099（AUC 0.886，P<0.0001）。
结论
AIP 是在 24 周之前识别妊娠糖尿病风险低的孕妇的有价值的指标。
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