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孕早期糖化血红蛋白、空腹血糖及体重指数在妊娠期糖尿病筛查中的临床价值

Clinical Value of Early-Pregnancy Glycated Hemoglobin, Fasting Plasma Glucose, and Body Mass Index in Screening Gestational Diabetes Mellitus.

作者信息

Lou Yanqin, Xiang Li, Gao Xuemei, Jiang Huijun

机构信息

Department of Obstetrics, The No. 1 Hospital of Wuhan, Wuhan, Hubei Province, China.

出版信息

Lab Med. 2022 Nov 3;53(6):619-622. doi: 10.1093/labmed/lmac058.

Abstract

OBJECTIVE

To investigate clinical values of early-pregnancy (8-13 weeks) glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body mass index (BMI) in screening gestational diabetes mellitus (GDM).

METHODS

A total of 1120 cases underwent a 75 g oral glucose tolerance test (OGTT), of which 216 cases with GDM were selected as the study group, and 278 cases without GDM were selected as the control group. FPG, HbA1c, and BMI in early pregnancy were measured. The correlation between FPG, HbA1c and BMI in early pregnancy and the incidence of GDM was analyzed by binary logistic regression, and the value of each index in predicting GDM alone or in combination was evaluated.

RESULTS

FPG, HbA1c, and BMI in early pregnancy in the GDM group were higher than those in the control group, and the differences were statistically significant (P < .05). Binary logistic regression analysis showed that FPG, HbA1c, and BMI were risk factors for GDM in early pregnancy (odds ratio [OR] values were 3.374 [P < .05], 4.644 [P < .001], and 1.077 [P < .001], respectively). The area under the receiver operating characteristic (ROC) curve of FPG, glycated hemoglobin, and BMI in screening GDM for early pregnancy were 0.647, 0.661, and 0.608, respectively, while the area under the ROC curve of the combination of these 3 indicators was 0.736.

CONCLUSION

We found that FPG, HbA1c, and BMI in early pregnancy might be the potential risk factors for the occurrence of GDM, and the combination of them had certain clinical predictive value for GDM. However, it is still necessary for more studies, especially prospective studies, to validate our findings in the future.

摘要

目的

探讨孕早期(8 - 13周)糖化血红蛋白(HbA1c)、空腹血糖(FPG)及体重指数(BMI)在妊娠期糖尿病(GDM)筛查中的临床价值。

方法

选取1120例行75g口服葡萄糖耐量试验(OGTT)的孕妇,其中216例GDM患者作为研究组,278例非GDM孕妇作为对照组。测定孕早期FPG、HbA1c及BMI。采用二元logistic回归分析孕早期FPG、HbA1c及BMI与GDM发生率的相关性,并评估各指标单独或联合预测GDM的价值。

结果

GDM组孕早期FPG、HbA1c及BMI均高于对照组,差异有统计学意义(P <.05)。二元logistic回归分析显示,FPG、HbA1c及BMI是孕早期GDM的危险因素(比值比[OR]值分别为3.374[P <.05]、4.644[P <.001]和1.077[P <.001])。FPG、糖化血红蛋白及BMI在孕早期筛查GDM的受试者工作特征(ROC)曲线下面积分别为0.647、0.661和0.608,而这3项指标联合的ROC曲线下面积为0.736。

结论

我们发现孕早期FPG、HbA1c及BMI可能是GDM发生的潜在危险因素,它们的联合对GDM有一定的临床预测价值。然而,未来仍需更多研究,尤其是前瞻性研究来验证我们的发现。

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