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利用胎盘应变弹性成像和皮下脂肪厚度预测妊娠期糖尿病。

Early Prediction of Gestational Diabetes Mellitus Using Placental Strain Elastography and Subcutaneous Adipose Tissue Thickness.

机构信息

Obstetrics and Gynecology Department, Izmir Katip Celebi University, Izmir, Turkey.

Obstetric and Gynecology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.

出版信息

Z Geburtshilfe Neonatol. 2023 Aug;227(4):269-276. doi: 10.1055/a-2109-4210. Epub 2023 Aug 16.

Abstract

AIM

The aim of this study is to investigate the efficacy of placental strain ratio values measured by real-time sonoelastography and maternal subcutaneous adipose tissue thickness measured by two-dimensional ultrasonography in predicting gestational diabetes mellitus in the first trimester.

MATERIALS AND METHODS

The population of the study consisted of the first 210 consecutive singleton pregnant women who applied for routine first-trimester screening between the 11th and 14th week of gestation.B-mode subcutaneous adipose tissue thickness sonography and real-time placental strain elastography scanning were performed.All patients underwent 75 g oral glucose tolerance test between the 24th and 28th week of gestation. American Diabetes Association criteria were used in the diagnosis of gestational diabetes mellitus.

RESULTS

It was observed that body mass index (p<0.001), first-trimester fasting blood sugar (p<0.001), subcutaneous adipose tissue thickness (p<0.001), and placental strain ratio value (p<0.001) affected the development of gestational diabetes mellitus statistically. The multivariate analysis shown that subcutaneous adipose tissue thickness (odds ratio=1.271, 95% CI=1.142-1.416, p<0.001) and placental strain ratio value (odds ratio=3.664, 95% CI=1.927-6.969, p<0.001) were the independent risk factors affecting the development of gestational diabetes mellitus.

CONCLUSIONS

The findings of this study indicated a positive correlation between 75 g oral glucose tolerance test application and first trimester subcutaneous adipose tissue thickness and placental strain ratio. Using the cut-off values of>11.5 mm for subcutaneous adipose tissue and>0.986 for placental strain ratio, the development of gestational diabetes mellitus may be predicted in the early weeks of pregnancy.

摘要

目的

本研究旨在探讨实时超声弹性成像测量的胎盘应变率比值与二维超声测量的母体皮下脂肪厚度在预测早孕期妊娠期糖尿病中的疗效。

材料与方法

本研究的研究人群为 210 例连续的单胎孕妇,这些孕妇在妊娠 11 至 14 周期间申请常规早孕期筛查。对所有患者进行 B 型超声皮下脂肪厚度超声检查和实时胎盘应变弹性成像扫描。所有患者均在妊娠 24 至 28 周进行 75g 口服葡萄糖耐量试验。采用美国糖尿病协会标准诊断妊娠期糖尿病。

结果

观察到体重指数(p<0.001)、早孕期空腹血糖(p<0.001)、皮下脂肪厚度(p<0.001)和胎盘应变率比值(p<0.001)对妊娠期糖尿病的发生有统计学影响。多变量分析显示,皮下脂肪厚度(比值比=1.271,95%置信区间=1.142-1.416,p<0.001)和胎盘应变率比值(比值比=3.664,95%置信区间=1.927-6.969,p<0.001)是影响妊娠期糖尿病发生的独立危险因素。

结论

本研究结果表明,75g 口服葡萄糖耐量试验与早孕期皮下脂肪厚度和胎盘应变率呈正相关。使用皮下脂肪厚度>11.5mm 和胎盘应变率比值>0.986 的截断值,可在妊娠早期预测妊娠期糖尿病的发生。

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