Khan Sikandar Hayat, Manzoor Robina, Baig Aasyia Hanif, Sobia Farah, Fazal Nadeem, Niazi Najmusaqib Khan
Department of Pathology, PNS Hafeez, Naval Hospital, Islamabad, Pakistan.
Department of Obstetrics & Gynecology, PNS Hafeez, Naval Hospital, Islamabad, Pakistan.
J Coll Physicians Surg Pak. 2019 Apr;29(4):333-336. doi: 10.29271/jcpsp.2019.04.333.
To evaluate glucose tolerance patterns in pregnant ladies undergoing 2-hour oral glucose tolerance test (OGTT) for comparing fasting, 1-hour, 2-hour post-glucose load results, HbA1c, sum of all glucose readings with and without gestational diabetes mellitus (GDM) using International Association of the Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria.
Cross-sectional analysis.
PNS Hafeez, Naval Hospital, Islamabad, from January 2016 to July 2017.
For 280 evaluated subjects reporting in mid-pregnancy for OGTT, results were segregated into four groups based upon comparison of 2-hour glucose result with 1-hour glucose. Group-1 2-hour results drop being >2.0 mmol/L than1-hour results, group-2 with 2-hour result between <2.0 to >0.5 mmol/L than peak at 1-hour, and group-3 with either 2-hour glucose drop being <0.5mmol/L or >1-hour results. Further, the ROC curve analysis was performed to compare the AUC for fasting plasma glucose, 1-hour post OGTT result, 2-hour post-OGTT result, factor additive of all OGTT readings and HbA1c.
There was a progressive rise in HbA1c from group-1 to group-3 (p<0.001). Area under curve (AUC) for various diagnostic parameters for diagnosing GDM for additive value of all glucose results was 0.962 (95% CI: 0.935-0.988), 0.881 (95% CI: 0.818-0944) for plasma glucose at 2-hour, for plasma glucose at 1-hour 0.898 (95% CI: 0.0.842-0.954), 0.831 (95% CI: 0.0.762-0.901) for fasting plasma glucose and 0.668 (95% CI: 0.0.578-0.759) for HbA1c (p<0.001).
Pregnant ladies demonstrating poor tolerance to glucose at 2-hour were observed to have higher HbA1c levels.
评估接受2小时口服葡萄糖耐量试验（OGTT）的孕妇的糖耐量模式，以比较空腹、葡萄糖负荷后1小时、2小时的结果、糖化血红蛋白（HbA1c），以及根据国际糖尿病与妊娠研究组（IADPSG）诊断标准划分的有无妊娠期糖尿病（GDM）的所有血糖读数总和。
横断面分析。
2016年1月至2017年7月，位于伊斯兰堡海军医院的PNS Hafeez。
对于280名在孕中期进行OGTT评估的受试者，根据2小时血糖结果与1小时血糖的比较，将结果分为四组。第1组2小时结果比1小时结果下降>2.0 mmol/L，第2组2小时结果比1小时峰值下降<2.0至>0.5 mmol/L，第3组2小时血糖下降<0.5 mmol/L或>1小时结果。此外，进行ROC曲线分析，以比较空腹血糖、OGTT后1小时结果、OGTT后2小时结果、所有OGTT读数的因子相加值和HbA1c的曲线下面积（AUC）。
从第1组到第3组，HbA1c呈逐渐上升趋势（p<0.001）。所有血糖结果相加值诊断GDM的各种诊断参数的曲线下面积（AUC）为0.962（95%CI：0.935 - 0.988），2小时血浆葡萄糖为0.881（95%CI：0.818 - 0.944），1小时血浆葡萄糖为0.898（95%CI：0.842 - 0.954），空腹血浆葡萄糖为0.831（95%CI：0.762 - 0.901），HbA1c为0.668（95%CI：0.578 - 0.759）（p<0.001）。
观察到2小时葡萄糖耐量差的孕妇HbA1c水平较高。
