Xiamen Diabetes Institute, Xiamen, China.
Xinglin Branch, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Sci Rep. 2019 Nov 5;9(1):15998. doi: 10.1038/s41598-019-52509-7.
Our aim is to assess the optimal cutoff value of fasting plasma glucose (FPG) in Chinese women at 24-28 weeks' gestation by performing oral glucose tolerance test (OGTT) to improve diagnostic rate of gestational diabetes mellitus (GDM). Data were derived from the Medical Birth Registry of Xiamen. A FPG cutoff value of 5.1 mmol/L confirmed the diagnosis of GDM in 4,794 (6.10%) pregnant women. However, a FPG cutoff value of 4.5 mmol/L should rule out the diagnosis of GDM in 35,932 (45.73%) pregnant women. If we use this cutoff value, the diagnosis of GDM to about 27.3% of pregnant women will be missed. Additionally, a 75-g OGTT was performed in pregnant women with FPG values between 4.5 and 5.1 mmol/L, avoiding the performance of formal 75-g OGTT in about 50.37% pregnant women. Meanwhile, according to maternal age and pre-pregnancy BMI categories, with FPG values between 4.5 mmol/L and 5.1 mmol/L, which had high sensitivity, to improve the diagnostic rate of GDM in all groups. Further researches are needed to present stronger evidences for the screening value of FPG in establishing the diagnosis of GDM in pregnant women.
我们的目的是通过口服葡萄糖耐量试验（OGTT）评估中国 24-28 周妊娠女性空腹血糖（FPG）的最佳截断值，以提高妊娠期糖尿病（GDM）的诊断率。数据来自厦门的医学出生登记处。FPG 截断值为 5.1mmol/L 可确诊 4794 名（6.10%）孕妇的 GDM。然而，FPG 截断值为 4.5mmol/L 可排除 35932 名（45.73%）孕妇的 GDM 诊断。如果使用该截断值，约 27.3%的孕妇的 GDM 诊断将会漏诊。此外，对于 FPG 值在 4.5 至 5.1mmol/L 之间的孕妇进行 75g OGTT，可以避免对约 50.37%的孕妇进行正式的 75g OGTT。同时，根据孕妇年龄和孕前 BMI 类别，FPG 值在 4.5mmol/L 至 5.1mmol/L 之间，具有较高的灵敏度，可提高所有组别的 GDM 诊断率。需要进一步的研究来为 FPG 在建立孕妇 GDM 诊断中的筛查价值提供更有力的证据。
