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一家三级转诊中心的妊娠期糖尿病患病率及筛查试验结果:一项横断面研究。

Prevalence of gestational diabetes mellitus and results of the screening tests at a tertiary referral center: A cross-sectional study.

作者信息

Ozgu-Erdinc A Seval, Sert Umit Yasemin, Buyuk Gul Nihal, Engin-Ustun Yaprak

机构信息

University of Health Sciences Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey.

出版信息

Diabetes Metab Syndr. 2019 Jan-Feb;13(1):74-77. doi: 10.1016/j.dsx.2018.08.019. Epub 2018 Aug 22.

DOI:10.1016/j.dsx.2018.08.019
PMID:30641799
Abstract

OBJECTIVE

This study aimed to identify the gestational diabetes mellitus (GDM) prevalence of low risk pregnant population at a tertiary referral center by different approaches.

MATERIAL AND METHODS

A cross-sectional study using retrospective data between 2007-2017 was conducted. During this period 77227 patients underwent either two step or one step glucose tolerance tests.

RESULTS

The median age of the study population was 27 (15-49). Fasting plasma glucose (FPG) testing was evaluated in 144,113 women at the initial antenatal care visit which %21 of these were between 92-126 mg/dL. Of these women %1.25 had FPG>126 mg/dL which showed the prevalence of pregestational diabetes in our cohort. During the study period 74412 women underwent 50-g glucose challenge test where %18 were screen positive and % 2.9 was defined as gestational diabetic without need for further testing (>180 mg/dL). The screening positive patients were sent to 100-g oral glucose tolerance test and the prevalence of GDM with two-step screening was 5.5%. A total of 2815 patients were screened by 75-g glucose tolerance test and the prevalence of GDM with one-step screening was 21%. Overall 4684 patients have been diagnosed as gestational diabetes mellitus with the prevalence of 6.07%.

CONCLUSION

Fasting plasma glucose >92 mg/dL is challenging in our population due to improper fasting. The FPG dependent GDM prevalence is almost four times higher than two-step glucose screening test results (21.8% vs 5.5%). If FPG levels will be used for diagnosing GDM then the values must be checked in a second laboratory analysis.

摘要

目的

本研究旨在通过不同方法确定某三级转诊中心低风险孕妇群体的妊娠期糖尿病(GDM)患病率。

材料与方法

采用回顾性数据进行横断面研究,研究时间为2007年至2017年。在此期间,77227例患者接受了两步或一步葡萄糖耐量试验。

结果

研究人群的中位年龄为27岁(15 - 49岁)。在首次产前检查时,对144113名女性进行了空腹血糖(FPG)检测,其中21%的女性FPG值在92 - 126mg/dL之间。这些女性中,1.25%的FPG>126mg/dL,这显示了我们队列中孕前糖尿病的患病率。在研究期间,74412名女性接受了50g葡萄糖耐量试验,其中18%筛查呈阳性,2.9%被定义为无需进一步检测的妊娠期糖尿病(>180mg/dL)。筛查呈阳性的患者被送去进行100g口服葡萄糖耐量试验,两步筛查的GDM患病率为5.5%。共有2815例患者通过75g葡萄糖耐量试验进行筛查,一步筛查的GDM患病率为21%。总体而言,4684例患者被诊断为妊娠期糖尿病,患病率为6.07%。

结论

由于禁食不当,在我们的人群中空腹血糖>92mg/dL具有挑战性。依赖FPG的GDM患病率几乎是两步葡萄糖筛查试验结果的四倍(21.8%对5.5%)。如果将FPG水平用于诊断GDM,那么必须在第二个实验室分析中检查这些值。

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