Braga Fernanda Oliveira, Negrato Carlos Antonio, Matta Maria de Fátima Bevilacqua da, Carneiro João Régis Ivar, Gomes Marília Brito
Unidade de Diabetes, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.
Associação dos Diabéticos de Bauru, Bauru, SP, Brasil.
Arch Endocrinol Metab. 2019 Feb;63(1):22-29. doi: 10.20945/2359-3997000000099.
The aim of this study was to evaluate the relationship between inflammatory cytokines, placental weight, glycated hemoglobin and adverse perinatal outcomes (APOs) in women with gestational diabetes mellitus (GDM).
This was a prospective, longitudinal and observational study conducted from April 2004 to November 2005 in Bauru, Brazil. Included patients had singleton pregnancies and performed a 100 g OGTT and had the levels of C-reactive protein (CRP), interleukin (IL)-6, TNF alfa and glycated hemoglobin (HbA1c) determined at 24-28th gestation weeks.
A total of 176 patients were included, of whom 78 had the diagnosis of GDM (44.3%). Multivariate analysis demonstrated that HbA1c, age, body mass index (BMI) and previous history of GDM were independent predictors for GDM diagnosis. ROC curve indicated that HbA1C levels ≥ 5.1% at 24-28 weeks gestation were associated with GDM. No difference was found in IL-6, tumor necrosis factor alpha (TNF-alpha) and CRP serum levels in women with and without GDM. Multivariate analysis showed that placental weight was significantly associated with APOs (p < 0.005), with a cut-off value of 610 grams as demonstrated by the ROC curve.
Placental weight ≥ 610 grams and HbA1C ≥ 5.1% were found to be associated with APOs and GDM, respectively, and their evaluation should be part of prenatal care routine.
本研究旨在评估妊娠期糖尿病（GDM）女性体内炎性细胞因子、胎盘重量、糖化血红蛋白与不良围产期结局（APO）之间的关系。
这是一项于2004年4月至2005年11月在巴西包鲁进行的前瞻性、纵向观察性研究。纳入的患者为单胎妊娠，进行了100克口服葡萄糖耐量试验（OGTT），并在妊娠第24 - 28周测定了C反应蛋白（CRP）、白细胞介素（IL）-6、肿瘤坏死因子α（TNF-α）和糖化血红蛋白（HbA1c）水平。
共纳入176例患者，其中78例被诊断为GDM（44.3%）。多因素分析表明，HbA1c、年龄、体重指数（BMI）和既往GDM病史是GDM诊断的独立预测因素。ROC曲线表明，妊娠24 - 28周时HbA1C水平≥5.1%与GDM相关。GDM患者与非GDM患者的IL-6、肿瘤坏死因子α（TNF-α）和CRP血清水平无差异。多因素分析显示，胎盘重量与APO显著相关（p < 0.005），ROC曲线显示临界值为610克。
胎盘重量≥610克和HbA1C≥5.1%分别与APO和GDM相关，对它们的评估应成为产前检查常规的一部分。
