Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Naternal Medicine, Medical University of Vienna, Vienna, Austria.
Center of Medical Statistics, Informatics, and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria.
J Diabetes Res. 2018 May 8;2018:3243754. doi: 10.1155/2018/3243754. eCollection 2018.
The aim of this study was to assess the association between OGTT glucose levels and requirement of pharmacotherapy in GDM patients classified by the IADPSG criteria. This study included 203 GDM patients (108 managed with lifestyle modification and 95 requiring pharmacotherapy). Clinical risk factors and OGTT glucose concentrations at 0 (G0), 60 (G60), and 120 min (G120) were collected. OGTT glucose levels were significantly associated with the later requirement of pharmacotherapy (ROC-AUC: 71.1, 95% CI: 63.8-78.3). Also, the combination of clinical risk factors (age, BMI, parity, and pharmacotherapy in previous gestation) showed an acceptable predictive accuracy (ROC-AUC: 72.1, 95% CI: 65.0-79.2), which was further improved when glycemic parameters were added (ROC-AUC: 77.5, 95% CI: 71.5-83.9). Random forest analysis revealed the highest variable importance for G0, G60, and age. OGTT glucose measures in addition to clinical risk factors showed promising properties for risk stratification in GDM patients classified by the recently established IADPSG criteria.
本研究旨在评估根据 IADPSG 标准分类的 GDM 患者中,OGTT 血糖水平与药物治疗需求之间的关联。本研究纳入了 203 例 GDM 患者(108 例接受生活方式改变治疗,95 例需要药物治疗)。收集了临床危险因素和 OGTT 各时间点(0 分钟[G0]、60 分钟[G60]和 120 分钟[G120])的血糖浓度。OGTT 血糖水平与后续药物治疗需求显著相关(ROC-AUC:71.1%,95%CI:63.8-78.3)。此外,临床危险因素(年龄、BMI、产次和既往妊娠中的药物治疗)的联合具有可接受的预测准确性(ROC-AUC:72.1%,95%CI:65.0-79.2),当加入血糖参数时预测准确性进一步提高(ROC-AUC:77.5%,95%CI:71.5-83.9)。随机森林分析显示 G0、G60 和年龄的变量重要性最高。除了临床危险因素外,OGTT 血糖测量对根据最近建立的 IADPSG 标准分类的 GDM 患者的风险分层具有良好的预测价值。