KhushBakht Dr, Mazhar Saadon, Bhalli Amanullah, Rashid Aqeela, Khan Khurshid, Jahanzaib Uzma
Department of Internal Medicine, Fauji Foundation Hospital, Lahore.
Department of Diagnostic Radiology, Lahore General Hospital, Lahore.
Cureus. 2018 May 28;10(5):e2699. doi: 10.7759/cureus.2699.
Introduction Due to normal physiological changes in various anthropometric indices during pregnancy, the routine measurements of body weight, height, waist circumference, and waist-to-hip ratio are deemed inappropriate in predicting obesity and risk of gestational diabetes mellitus in pregnancy. Neck circumference is a novel marker to determine the risk of gestational diabetes in pregnancy. We conducted this study to determine the correlation between neck circumference and gestational diabetes mellitus and its associated risk factors. Methods This was an observational, cross-sectional study conducted at Jinnah Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE), Allama Iqbal Medical College/ Jinnah Hospital, Lahore from July 2017 to March 2018. Pregnant females at 16 weeks of gestation underwent measurement of weight, height, body mass index, neck, and waist circumference. At the 24 gestational week, an oral glucose test was conducted and fasting lipid profile, serum albumin, and uric acid were measured. Pearson's correlation was used to see any correlation between neck circumference and gestational diabetes and its associated risk factors. Results There were 90 subjects in the study with a mean age 30.8 ± 3.2 (range: 26 - 34) years. The waist and neck circumference at 16 weeks of gestation measured 104.2 ± 9.0 cm and 36.1 ± 2.8 cm, respectively. Age, weight, waist circumference, and body mass index were positively and significantly correlated with neck circumference (p-value < 0.05). After adjusting for age, the correlation between neck circumference and weight, waist circumference, and body mass index (BMI) was statistically significant with a p-value < 0.05. Analysis of the receiver operating curve revealed that the cut-off value of neck circumference for predicting gestational diabetes was 35.70 cm with a sensitivity of 51.4% and specificity of 81.2%. Conclusion Neck circumference at the 16 gestational week is a reliable and valid tool to predict gestational diabetes mellitus at 24 weeks of gestation.
引言 由于孕期各种人体测量指标会发生正常的生理变化，因此常规测量体重、身高、腰围和腰臀比在预测孕期肥胖和妊娠糖尿病风险方面被认为并不合适。颈围是确定孕期妊娠糖尿病风险的一个新指标。我们开展这项研究以确定颈围与妊娠糖尿病及其相关危险因素之间的相关性。
方法 这是一项于2017年7月至2018年3月在拉合尔市真纳·阿拉马·伊克巴尔糖尿病与内分泌研究所（JAIDE）、阿拉马·伊克巴尔医学院/真纳医院进行的观察性横断面研究。妊娠16周的孕妇接受了体重、身高、体重指数、颈围和腰围的测量。在妊娠24周时，进行了口服葡萄糖试验，并测量了空腹血脂谱、血清白蛋白和尿酸。采用Pearson相关性分析来观察颈围与妊娠糖尿病及其相关危险因素之间的任何相关性。
结果 该研究中有90名受试者，平均年龄为30.8±3.2（范围：26 - 34）岁。妊娠16周时的腰围和颈围分别测量为104.2±9.0厘米和36.1±2.8厘米。年龄、体重、腰围和体重指数与颈围呈正相关且具有显著相关性（p值<0.05）。在对年龄进行校正后，颈围与体重、腰围和体重指数（BMI）之间的相关性具有统计学意义，p值<0.05。对受试者工作曲线的分析显示，预测妊娠糖尿病的颈围截断值为35.70厘米，敏感性为51.4%，特异性为81.2%。
结论 妊娠16周时的颈围是预测妊娠24周时妊娠糖尿病的可靠且有效的工具。
