Carpenter M W, Coustan D R, Widness J A, Gruppuso P A, Malone M, Rotondo L M
Department of Obstetrics and Gynecology, Brown University Program in Medicine, Providence, RI.
Am J Obstet Gynecol. 1988 Nov;159(5):1128-31. doi: 10.1016/0002-9378(88)90428-0.
Gestational diabetes is a predictor of glucose intolerance in subsequent pregnancies and in the nongravid state. Many pregnant women are not tested for gestational diabetes, although they or their offspring may show signs suggestive of antecedent hyperglycemia. We examined the diagnostic utility of a postpartum (within 48 hours), 100 gm, oral glucose tolerance test and cord plasma glucose, cord plasma C-peptide, and 2-hour neonatal plasma glucose tests to detect antecedent gestational diabetes in women with documented gestational diabetes (n = 37) or with normal glucose tolerance test results late in the third trimester (n = 28). The 1-hour, 2-hour, and incremental 1-hour + 2-hour [( 1-hour - fasting] + [2-hour - fasting]) [2-hour - fasting]) glucose values of the postpartum glucose tolerance test showed significant differences between study participants with and without gestational diabetes (164 +/- 30 versus 115 +/- 22, 145 +/- 31 versus 101 +/- 21, and 153 +/- 51 versus 67 +/- 33 mg/dl, respectively, p less than 0.025). Maternal fasting and 3-hour postpartum glucose tolerance test glucose, cord plasma glucose, cord plasma C-peptide, and 2-hour neonatal plasma glucose values showed no significant between-group differences. Receiver operating characteristic curve analyses for these tests indicated that the incremental 1-hour + 2-hour postpartum glucose tolerance test glucose values best sustain test specificity at the low test threshold values necessary for high test sensitivity. A threshold of 110 mg/dl for this test yielded a predicted specificity of 90% and sensitivity of 80% with regard to antecedent gestational diabetes.
妊娠期糖尿病是后续妊娠及非孕期糖耐量异常的一个预测指标。许多孕妇未接受妊娠期糖尿病检测，尽管她们或其后代可能出现提示既往高血糖的体征。我们检测了产后（48小时内）100克口服葡萄糖耐量试验以及脐血血浆葡萄糖、脐血血浆C肽和2小时新生儿血浆葡萄糖检测对已确诊妊娠期糖尿病的女性（n = 37）或孕晚期糖耐量试验结果正常的女性（n = 28）既往妊娠期糖尿病的诊断效用。产后葡萄糖耐量试验的1小时、2小时以及增量1小时 + 2小时[（1小时 - 空腹）+（2小时 - 空腹）]葡萄糖值在有和无妊娠期糖尿病的研究参与者之间显示出显著差异（分别为164±30与115±22、145±31与101±21以及153±51与67±33毫克/分升，p<0.025）。母体空腹及产后3小时葡萄糖耐量试验葡萄糖、脐血血浆葡萄糖、脐血血浆C肽和2小时新生儿血浆葡萄糖值在组间未显示出显著差异。这些检测的受试者工作特征曲线分析表明，增量1小时 + 2小时产后葡萄糖耐量试验葡萄糖值在高检测灵敏度所需的低检测阈值下能最好地维持检测特异性。该检测阈值为110毫克/分升时，对于既往妊娠期糖尿病的预测特异性为90%，灵敏度为80%。
