Seth Isha, Aiyappan Ram K, Singh Sunayana, Seth Aditya, Sharma Deepti, K Janu M, Krishnan Vivek, Seth Arushi, Yadav Chander Mohan, Jain Harsh
Obstetrics and Gynaecology, Amrita Hospital, Faridabad, IND.
General Surgery, Amrita Hospital, Faridabad, IND.
Cureus. 2023 Feb 3;15(2):e34610. doi: 10.7759/cureus.34610. eCollection 2023 Feb.
Background This study aimed to determine whether mid-trimester fetal anterior abdominal wall subcutaneous tissue thickness (FASTT) is an early sonographic predictor of gestational diabetes mellitus (GDM), as well as to study its correlation with maternal glycemic values on GDM screening at 24-28 weeks. Methodology We conducted a prospective, case-control study. FASTT was assessed at anomaly scan in 896 uncomplicated singleton pregnancies. The 75-gram oral glucose tolerance test (OGTT) was done for all included patients at 24-28 weeks. Women diagnosed with GDM were taken as cases and appropriately matched in equal numbers as controls. Statistical analysis was done using SPSS version 20 (IBM Corp., Armonk, NY, USA). Independent-samples t-test, chi-square test, receiver operating characteristic curve, and Pearson's correlation coefficient (r) were performed wherever applicable. Results A total of 93 cases and 94 controls were included. Fetuses of women with GDM had significantly higher mean FASTT at 20 weeks (1.605 ± 0.328 mm vs. 1.222 ± 0.121 mm; p < 0.001). The FASTT cut-off obtained was 1.35 mm (sensitivity = 79.6%, specificity = 87.2%, positive predictive value = 86%, negative predictive value = 81.2%). There was a moderate positive correlation between fasting blood sugar (FBS) and two-hour OGTT values and FASTT (r = 0.332, p < 0.001 and r = 0.399, p < 0.001, respectively). FASTT >1.35 mm had an independent predictive value for GDM and was associated with a 19.608-fold increased risk of GDM. Conclusions FASTT values greater than 1.35 mm at 20 weeks are associated with a significantly increased risk of GDM. In addition, FASTT correlates with FBS and two-hour OGTT at 24-28 weeks and is a simple predictor of GDM at 18-20 weeks.
背景 本研究旨在确定孕中期胎儿前腹壁皮下组织厚度（FASTT）是否为妊娠期糖尿病（GDM）的早期超声预测指标，并研究其与24 - 28周GDM筛查时母体血糖值的相关性。
方法 我们进行了一项前瞻性病例对照研究。对896例无并发症的单胎妊娠进行了异常扫描时的FASTT评估。所有纳入患者在24 - 28周时进行了75克口服葡萄糖耐量试验（OGTT）。被诊断为GDM的女性作为病例，并以相等数量适当匹配作为对照。使用SPSS 20版（美国纽约州阿蒙克市IBM公司）进行统计分析。在适用的情况下进行独立样本t检验、卡方检验、受试者工作特征曲线和Pearson相关系数（r）分析。
结果 共纳入93例病例和94例对照。GDM女性的胎儿在20周时的平均FASTT显著更高（1.605±0.328毫米对1.222±0.121毫米；p<0.001）。获得的FASTT临界值为1.35毫米（敏感性 = 79.6%，特异性 = 87.2%，阳性预测值 = 86%，阴性预测值 = 81.2%）。空腹血糖（FBS）和两小时OGTT值与FASTT之间存在中度正相关（r分别为0.332，p<0.001和r为0.399，p<0.001）。FASTT>1.35毫米对GDM具有独立预测价值，且与GDM风险增加19.608倍相关。
结论 20周时FASTT值大于1.35毫米与GDM风险显著增加相关。此外，FASTT与24 - 28周时的FBS和两小时OGTT相关，是18 - 20周时GDM的一个简单预测指标。
