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基于列线图模型的多囊卵巢综合征妇女妊娠糖尿病风险预测。

Risk prediction of gestational diabetes mellitus in women with polycystic ovary syndrome based on a nomogram model.

机构信息

Hunan Provincial Maternal and Child Health Care Hospital, 53, Xiangchun Road, Changsha, Hunan, People's Republic of China.

出版信息

BMC Pregnancy Childbirth. 2023 Jun 2;23(1):408. doi: 10.1186/s12884-023-05670-x.

Abstract

Women with polycystic ovary syndrome are prone to develop gestational diabetes mellitus, a disease which may have significant impact on the postpartum health of both mother and infant. We performed a retrospective cohort study to develop and test a model that could predict gestational diabetes mellitus in the first trimester in women with polycystic ovary syndrome. Our study included 434 pregnant women who were referred to the obstetrics department between December 2017 and March 2020 with a diagnosis of polycystic ovary syndrome. Of these women, 104 were diagnosed with gestational diabetes mellitus in the second trimester. Univariate analysis revealed that in the first trimester, Hemoglobin A1c (HbA1C), age, total cholesterol(TC), low-density lipoprotein cholesterol (LDL-C), SBP (systolic blood pressure), family history, body mass index (BMI), and testosterone were predictive factors of gestational diabetes mellitus (P < 0.05). Logistic regression revealed that TC, age, HbA1C, BMI and family history were independent risk factors for gestational diabetes mellitus. The area under the ROC curve of the gestational diabetes mellitus risk prediction model was 0.937 in this retrospective analysis, demonstrating a great discriminatory ability. The sensitivity and specificity of the prediction model were 0.833 and 0.923, respectively. The Hosmer-Lemeshow test also showed that the model was well calibrated.

摘要

患有多囊卵巢综合征的女性易患妊娠期糖尿病,这可能对母婴产后健康产生重大影响。我们进行了一项回顾性队列研究,旨在开发和验证一种能够预测多囊卵巢综合征女性早期妊娠期糖尿病的模型。我们的研究纳入了 2017 年 12 月至 2020 年 3 月期间因多囊卵巢综合征就诊妇产科的 434 名孕妇,其中 104 名孕妇在孕中期被诊断为妊娠期糖尿病。单因素分析显示,在孕早期,糖化血红蛋白(HbA1C)、年龄、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、家族史、体重指数(BMI)和睾酮是妊娠期糖尿病的预测因素(P<0.05)。Logistic 回归分析显示,TC、年龄、HbA1C、BMI 和家族史是妊娠期糖尿病的独立危险因素。在这项回顾性分析中,妊娠期糖尿病风险预测模型的 ROC 曲线下面积为 0.937,具有很好的判别能力。预测模型的灵敏度和特异度分别为 0.833 和 0.923。Hosmer-Lemeshow 检验也表明模型拟合良好。

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