东亚妊娠期糖尿病女性产后发生糖尿病的风险及葡萄糖耐量异常的预测因素。
Postpartum risk of diabetes and predictive factors for glucose intolerance in East Asian women with gestational diabetes.
机构信息
Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan; Division of Metabolism and Endocrinology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan; Division of Metabolism and Endocrinology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
出版信息
Diabetes Res Clin Pract. 2018 Jun;140:1-8. doi: 10.1016/j.diabres.2018.03.031. Epub 2018 Mar 26.
AIMS
Women with a history of gestational diabetes mellitus (GDM) are likely to develop postpartum diabetes mellitus (DM). We examined women in the early stages of pregnancy who were at high risk of postpartum DM progression to establish a follow-up method for early detection.
METHODS
We performed the oral glucose tolerance test (OGTT) and identified predictive factors for postpartum impaired glucose tolerance (IGT) or DM in 77 women after GDM, for 2 years after delivery, retrospectively. Cutoff values for each factor were determined. We classified these women with GDM into four groups using these predictive factors and evaluated postpartum glucose intolerance (GI) in each group.
RESULTS
In total, 44.1% of the women with a GDM history had developed postpartum GI within 2 years. We determined three risk factors for postpartum GI: elevated glucose level 120 min after a 75-g OGTT (Glu120), elevated glycated hemoglobin (HbA1c) level at diagnosis, and perinatal complications. The cutoff Glu120 and the HbA1c level were 155 mg/dl and 5.3% (34 mmol/mol), respectively. Type 2 DM developed in 53.8% of women, and IGT developed in 38.5% of women within 2 years in groups with high Glu120 and high HbA1c.
CONCLUSIONS
High-risk groups require careful follow-up observation.
目的
有妊娠糖尿病（GDM）病史的女性可能会发展为产后糖尿病（DM）。我们检查了处于妊娠早期且有发生产后 DM 进展高危风险的女性，以建立一种用于早期检测的随访方法。
方法
我们对 77 名 GDM 后女性进行了口服葡萄糖耐量试验（OGTT），并回顾性地确定了这些女性在产后 2 年内发生糖耐量受损（IGT）或 DM 的预测因素。确定了每个因素的截断值。我们使用这些预测因素将这些患有 GDM 的女性分为四组，并评估每组的产后糖不耐受（GI）。
结果
共有 44.1%的 GDM 病史女性在 2 年内发生了产后 GI。我们确定了产后 GI 的三个危险因素：OGTT 后 120 分钟葡萄糖水平升高（Glu120）、诊断时糖化血红蛋白（HbA1c）水平升高以及围产期并发症。Glu120 和 HbA1c 的截断值分别为 155mg/dl 和 5.3%（34mmol/mol）。2 年内，53.8%的女性发展为 2 型糖尿病，高 Glu120 和高 HbA1c 组的女性中有 38.5%发展为 IGT。
结论
高危组需要密切随访观察。
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