Rajab Khalil E, Skerman Jonathan H, Issa Abdulla A
Department of Obstetrics and Gynaecology, Department of Anaesthesia and Intensive Care, Arabian Gulf University, College of Medicine and Medical Sciences, Salmaniya Medical Complex, P.O.Box 26752, Manama, Kingdom of Bahrain.
J Sci Res Med Sci. 2003 Aug;5(1-2):5-8.
(a) To test the sensitivity and specificity of measuring fasting plasma glucose levels (FPG) as a screening test for gestational diabetes mellitus (GDM). (b) To compare predicting levels of FPG levels with the one-hour, oral 50g non-fasting glucose challenge test (GCT) for predicting GDM.
One thousand and six hundred pregnant women from the Health Centres, antenatal clinics and Salmaniya Medical Complex were screened by the GCT after 50g of oral glucose during 26-32 weeks gestation, giving a 13.5% incidence of GDM (using the Third International Workshop cutoff values of 7.8 mmol /l). All patients also had an FPG estimation followed by the three-hour oral glucose tolerance test (oGTT). Seventy eight percent of the patients were Bahraini, 19% Asian and 3% other nationalities. Their mean age was 27.2+0.2 years. Receiver-operating curves (ROC) were used to test the ability of the FPG and the oGTT to differentiate patients with GDM and identify the cut off values for predicting a diagnosis of GDM.
FPG levels of 5.6 mmol /l and 5.4 mmol /l yielded sensitivities and specificities of 94% and 93% respectively. Measuring FPG as a screening test required a diagnostic oGTT in 32% compared with 13% when the GCT was used.
Using FPG levels at a cutoff value of ≥ 5.5 mmol /l is an easier, more acceptable test for patients compared to the GCT. Using the FPG levels is also more cost effective and allows nearly 70% of women to avoid the oGTT.
（a）检测空腹血糖水平（FPG）作为妊娠期糖尿病（GDM）筛查试验的敏感性和特异性。（b）比较FPG水平与1小时口服50g非空腹葡萄糖耐量试验（GCT）预测GDM的能力。
对来自健康中心、产前诊所和萨勒曼尼亚医疗中心的1600名孕妇在妊娠26 - 32周口服50g葡萄糖后进行GCT筛查，GDM发病率为13.5%（采用第三届国际研讨会7.8 mmol /l的临界值）。所有患者均进行了FPG测定，随后进行了3小时口服葡萄糖耐量试验（oGTT）。78%的患者为巴林人，19%为亚洲人，3%为其他国籍。她们的平均年龄为27.2±0.2岁。采用受试者操作特征曲线（ROC）来检测FPG和oGTT区分GDM患者的能力，并确定预测GDM诊断的临界值。
FPG水平为5.6 mmol /l和5.4 mmol /l时，敏感性和特异性分别为94%和93%。将FPG作为筛查试验时，32%的患者需要进行诊断性oGTT，而使用GCT时这一比例为13%。
与GCT相比，采用≥5.5 mmol /l的FPG临界值对患者来说是一种更简便、更易接受的检测方法。使用FPG水平检测成本效益更高，且能使近70%的女性避免进行oGTT。
