24-28 周空腹血糖筛查妊娠期糖尿病：来自中国的新证据。
Fasting plasma glucose at 24-28 weeks to screen for gestational diabetes mellitus: new evidence from China.
机构信息
Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
出版信息
Diabetes Care. 2013 Jul;36(7):2038-40. doi: 10.2337/dc12-2465. Epub 2013 Mar 27.
Abstract
OBJECTIVE
To evaluate the usefulness of a fasting plasma glucose (FPG) at 24-28 weeks' gestation to screen for gestational diabetes mellitus (GDM).
RESEARCH DESIGN AND METHODS
The medical records and results of a 75-g 2-h oral glucose tolerance test (OGTT) of 24,854 pregnant women without known pre-GDM attending prenatal clinics in 15 hospitals in China were examined.
RESULTS
FPG cutoff value of 5.1 mmol/L identified 3,149 (12.1%) pregnant women with GDM. FPG cutoff value of 4.4 mmol/L ruled out GDM in 15,369 (38.2%) women. With use of this cutoff point, 12.2% of patients with mild GDM will be missed. The positive predictive value is 0.322, and the negative predictive value is 0.928.
CONCLUSIONS
FPG at 24-28 weeks' gestation could be used as a screening test to identify GDM patients in low-resource regions. Women with an FPG between ≥4.4 and ≤5.0 mmol/L would require a 75-g OGTT to diagnose GDM. This would help to avoid approximately one-half (50.3%) of the formal 75-g OGTTs in China.
摘要
目的
评估妊娠 24-28 周时的空腹血糖（FPG）在筛查妊娠期糖尿病（GDM）方面的作用。
研究设计和方法
对中国 15 家医院的 24854 名无已知孕前 GDM 的孕妇的病历和 75g 2 小时口服葡萄糖耐量试验（OGTT）结果进行了检查。
结果
FPG 截断值为 5.1mmol/L 时，可诊断出 3149 名（12.1%）患有 GDM 的孕妇。FPG 截断值为 4.4mmol/L 时，可排除 15369 名（38.2%）孕妇的 GDM。使用该截断点，将错过 12.2%的轻度 GDM 患者。阳性预测值为 0.322，阴性预测值为 0.928。
结论
妊娠 24-28 周时的 FPG 可作为一种筛查试验，用于识别资源匮乏地区的 GDM 患者。FPG 在 4.4mmol/L 至 5.0mmol/L 之间的女性需要进行 75g OGTT 以诊断 GDM。这将有助于避免在中国进行的约一半（50.3%）正式 75g OGTT。
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