妊娠期糖尿病：一刀切是否可行？对全球统一诊断阈值的挑战。
Gestational Diabetes Mellitus: Does One Size Fit All? A Challenge to Uniform Worldwide Diagnostic Thresholds.
机构信息
Mater Research and Mater Clinical Unit, The University of Queensland, South Brisbane, Queensland, Australia
Danish Diabetes Academy, Odense University Hospital, Odense, Denmark.
出版信息
Diabetes Care. 2018 Jul;41(7):1339-1342. doi: 10.2337/dc17-2393. Epub 2018 Mar 20.
OBJECTIVE
To define the prevalence and pregnancy outcomes related to elevated fasting venous plasma glucose (FVPG) in a Danish pregnancy cohort.
RESEARCH DESIGN AND METHODS
This was an observational cohort study including 1,516 women without gestational diabetes mellitus (GDM) by Danish criteria. FVPG measured at 28 weeks' gestation was related to pregnancy outcomes.
RESULTS
With use of the World Health Organization (WHO) 2013 threshold of FVPG ≥5.1 mmol/L, 40.1% of the cohort qualified as having GDM. There was no evidence of excess fetal growth, hypertension in pregnancy, or cesarean delivery in women with FVPG <5.6 mmol/L.
CONCLUSIONS
The WHO 2013 FVPG threshold for GDM is unsuitable for Denmark. It inappropriately labels as having GDM an unmanageably large number of women who are at low absolute risk of pregnancy complications.
目的
在丹麦妊娠队列中定义空腹静脉血浆葡萄糖（FVPG）升高的流行率和妊娠结局。
研究设计和方法
这是一项观察性队列研究，纳入了 1516 名不符合丹麦标准的妊娠期糖尿病（GDM）的女性。在 28 周妊娠时测量的 FVPG 与妊娠结局相关。
结果
使用世界卫生组织（WHO）2013 年 FVPG≥5.1mmol/L 的标准，有 40.1%的队列被归类为 GDM。在 FVPG<5.6mmol/L 的女性中，没有胎儿生长过度、妊娠高血压或剖宫产的证据。
结论
WHO 2013 年 FVPG 诊断 GDM 的标准不适合丹麦。它不恰当地将大量处于低绝对妊娠并发症风险的女性标记为患有 GDM。
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