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中国妊娠期糖尿病女性糖化白蛋白水平与血糖控制及出生体重之间的关联

Association between glycemic control and birthweight with glycated albumin in Chinese women with gestational diabetes mellitus.

作者信息

Li Hua-Ping, Wang Feng-Huan, Tao Min-Fang, Huang Ya-Juan, Jia Wei-Ping

机构信息

Department of Gynecology & Obstetrics Shanghai Clinical Center for Diabetes Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China.

Department of Gynecology & Obstetrics Shenzhou City Hospital Shenzhou Hebei China.

出版信息

J Diabetes Investig. 2016 Jan;7(1):48-55. doi: 10.1111/jdi.12383. Epub 2015 Jul 14.

Abstract

AIMS/INTRODUCTION: To assess glycated albumin (GA) as a potential glycemic index in managing gestational diabetes mellitus (GDM).

MATERIALS AND METHODS

Eligible pregnant women were divided into the GDM group with abnormal result on a 75-g oral glucose tolerance test (OGTT) and the control (normal) group. GA measurements, Pearson's correlation analysis, multiple logistic regression and receiver operating characteristic curve analysis were obtained at the follow-up examination of participants in the two groups.

RESULTS

A total of 2,118 women were assigned to the GDM group (n = 639) and control group (n = 1,479). The mean level of serum GA in GDM group was significantly greater than that in the control group at both 24-28 and 36-38 weeks of gestation (P < 0.05). The area under the receiver operating characteristic curve for GA defining good glycemic control in GDM was 0.874 (95% confidence interval 0.811-0.938). The cut-off point for the GA levels derived from the receiver operating characteristic curve was 11.60%, which had sensitivity and specificity for detecting a poor glycemic status of 75.93% and 86.36%, respectively. The risk of birthweight ≥3,500 g and macrosomia increased significantly with GA levels ≥13.00% at 24-28 weeks and ≥12.00% at 36-38 weeks of gestation.

CONCLUSIONS

GA might be an appropriate and conveniently measured index that can detect poor glycemic control and predict birthweights in GDM women.

摘要

目的/引言:评估糖化白蛋白(GA)作为管理妊娠期糖尿病(GDM)潜在血糖指标的作用。

材料与方法

符合条件的孕妇分为口服75克葡萄糖耐量试验(OGTT)结果异常的GDM组和对照组(正常组)。在两组参与者的随访检查中进行GA测量、Pearson相关性分析、多元逻辑回归和受试者工作特征曲线分析。

结果

共有2118名女性被分配到GDM组(n = 639)和对照组(n = 1479)。在妊娠24 - 28周和36 - 38周时,GDM组血清GA的平均水平均显著高于对照组(P < 0.05)。GA用于定义GDM良好血糖控制的受试者工作特征曲线下面积为0.874(95%置信区间0.811 - 0.938)。从受试者工作特征曲线得出的GA水平截断点为11.60%,其检测血糖状态不佳的敏感性和特异性分别为75.93%和86.36%。在妊娠24 - 28周时GA水平≥13.00%以及36 - 38周时≥12.00%时,出生体重≥3500克和巨大儿的风险显著增加。

结论

GA可能是一个合适且便于测量的指标,可用于检测GDM女性的血糖控制不佳情况并预测出生体重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd92/4718110/3f6aad3326b3/JDI-7-048-g001.jpg

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