Benhalima Katrien, Van Crombrugge Paul, Moyson Carolien, Verhaeghe Johan, Vandeginste Sofie, Verlaenen Hilde, Vercammen Chris, Maes Toon, Dufraimont Els, De Block Christophe, Jacquemyn Yves, Mekahli Farah, De Clippel Katrien, Van Den Bruel Annick, Loccufier Anne, Laenen Annouschka, Minschart Caro, Devlieger Roland, Mathieu Chantal
Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
Department of Endocrinology, OLV Ziekenhuis Aalst-Asse-Ninove, Moorselbaan 164, 9300 Aalst, Belgium.
J Clin Med. 2019 Mar 19;8(3):383. doi: 10.3390/jcm8030383.
Predictors for glucose intolerance postpartum were evaluated in women with gestational diabetes mellitus (GDM) based on the 2013 World Health Organization (WHO) criteria. 1841 women were tested for GDM in a prospective cohort study. A postpartum 75g oral glucose tolerance test (OGTT) was performed in women with GDM at 14 ± 4.1 weeks. Of all 231 mothers with GDM, 83.1% (192) had a postpartum OGTT of which 18.2% (35) had glucose intolerance. Women with glucose intolerance were more often of Asian origin [15.1% vs. 3.7%, OR 4.64 (1.26⁻17.12)], had more often a recurrent history of GDM [41.7% vs. 26.7%, OR 3.68 (1.37⁻9.87)], higher fasting glycaemia (FPG) [5.1 (4.5⁻5.3) vs. 4.6 (4.3⁻5.1) mmol/L, OR 1.05 (1.01⁻1.09)], higher HbA1c [33 (31⁻36) vs. 32 (30⁻33) mmol/mol, OR 4.89 (1.61⁻14.82)], and higher triglycerides [2.2 (1.9⁻2.8) vs. 2.0 (1.6⁻2.5) mmol/L, OR 1.00 (1.00⁻1.01)]. Sensitivity of glucose challenge test (GCT) ≥7.2 mmol/l for glucose intolerance postpartum was 80% (63.1%⁻91.6%). The area under the curve to predict glucose intolerance was 0.76 (0.65⁻0.87) for FPG, 0.54 (0.43⁻0.65) for HbA1c and 0.75 (0.64⁻0.86) for both combined. In conclusion, nearly one-fifth of women with GDM have glucose intolerance postpartum. A GCT ≥7.2 mmol/L identifies a high risk population for glucose intolerance postpartum.
基于2013年世界卫生组织（WHO）标准，对患有妊娠期糖尿病（GDM）的女性产后葡萄糖耐量异常的预测因素进行了评估。在一项前瞻性队列研究中，对1841名女性进行了GDM检测。对患有GDM的女性在14±4.1周时进行产后75克口服葡萄糖耐量试验（OGTT）。在所有231名患有GDM的母亲中，83.1%（192名）进行了产后OGTT，其中18.2%（35名）有葡萄糖耐量异常。葡萄糖耐量异常的女性更常为亚洲血统[15.1%对3.7%，比值比（OR）4.64（1.26 - 17.12）]，更常有GDM复发史[41.7%对26.7%，OR 3.68（1.37 - 9.87）]，空腹血糖（FPG）更高[5.1（4.5 - 5.3）对4.6（4.3 - 5.1）mmol/L，OR 1.05（1.01 - 1.09）]，糖化血红蛋白（HbA1c）更高[33（31 - 36）对32（30 - 33）mmol/mol，OR 4.89（1.61 - 14.82）]，甘油三酯更高[2.2（1.9 - 2.8）对2.0（1.6 - 2.5）mmol/L，OR 1.00（1.00 - 1.01）]。葡萄糖筛查试验（GCT）≥7.2 mmol/l对产后葡萄糖耐量异常的敏感性为80%（63.1% - 91.6%）。预测葡萄糖耐量异常的曲线下面积，FPG为0.76（0.65 - 0.87），HbA1c为0.54（0.43 - 0.65），两者联合为0.75（0.64 - 0.86）。总之，近五分之一的GDM女性产后有葡萄糖耐量异常。GCT≥7.2 mmol/L可识别出产后葡萄糖耐量异常的高危人群。
