Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Health Information Technology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Clin Nutr ESPEN. 2023 Oct;57:469-474. doi: 10.1016/j.clnesp.2023.07.084. Epub 2023 Jul 26.
Gestational diabetes mellitus (GDM) is associated with a considerable risk of diabetes in the future. Few studies focused on the association between hemoglobin levels and developing gestational diabetes. This study aimed to determine the association of hemoglobin in early pregnancy and developing gestational diabetes mellitus.
A prospective registry cohort study was designed for the recall of women with gestational diabetes mellitus. The registry was implemented in the health centers of Ahvaz City in 2019. Biological and clinical assessments were done, and interviewer-administered questionnaires were used to collect data on socio-demographic Features, medical and obstetric history, and risk factors of GDM. SPSS used for data analysis. The optimal hemoglobin cut-off point, its sensitivity, and specificity for the prediction of GDM were estimated using ROC analysis.
The prevalence of anemia was 17.1% in pregnant women (8.1% in women with gestational diabetes versus %24.2% in the healthy group, p < 0.001). The hemoglobin mean in women with GDM was significantly higher than in healthy women (P < 0.001). Hemoglobin at the first visit was significantly associated with a greater risk of gestational diabetes (OR = 3.80, 95% CI: 3.05-4.74). The area under the curve (AUC) was 0.76 (95% CI 0.73-79), and the optimal cut-off point for hemoglobin was 11.90 g/dL, with a sensitivity of 75% and a specificity of 68%. Women with a higher hemoglobin level had a 3.8- more risk of developing GDM.
Measurement of hemoglobin can be a relatively good tool for predicting gestational diabetes in the first months of pregnancy. The combination of hemoglobin with fasting blood sugar and BMI improves the predictive value for gestational diabetes incidence.
妊娠期糖尿病（GDM）与未来发生糖尿病的风险相当高。很少有研究关注血红蛋白水平与发生妊娠期糖尿病之间的关系。本研究旨在确定孕早期血红蛋白与发生妊娠期糖尿病之间的关系。
本研究设计了一项前瞻性登记队列研究，以召回患有妊娠期糖尿病的女性。该登记于 2019 年在阿瓦士市的卫生中心进行。进行了生物学和临床评估，并使用访谈者管理的问卷收集了社会人口特征、医疗和产科史以及 GDM 风险因素的数据。使用 SPSS 进行数据分析。使用 ROC 分析估计最佳血红蛋白截断点、其对 GDM 的预测的敏感性和特异性。
孕妇贫血的患病率为 17.1%（妊娠期糖尿病妇女为 8.1%，健康组为 24.2%，p<0.001）。患有 GDM 的女性的血红蛋白平均值明显高于健康女性（P<0.001）。首次就诊时的血红蛋白与妊娠期糖尿病的风险显著相关（OR=3.80，95%CI：3.05-4.74）。曲线下面积（AUC）为 0.76（95%CI 0.73-79），血红蛋白的最佳截断点为 11.90g/dL，灵敏度为 75%，特异性为 68%。血红蛋白水平较高的女性发生 GDM 的风险增加 3.8 倍。
血红蛋白的测量可以是预测妊娠早期妊娠期糖尿病的相对较好的工具。将血红蛋白与空腹血糖和 BMI 结合使用可以提高对妊娠期糖尿病发生率的预测价值。
