Li Xiaojing, Bai Liwei, Niu Ziru, Lu Qiang
Department of Obstetrics, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People's Republic of China.
Department of Obstetrics, Qinhuangdao Hospital for Maternal and Child Health, Qinhuangdao, Hebei, 066000, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Dec 23;16:4179-4185. doi: 10.2147/DMSO.S439413. eCollection 2023.
The objective of this study was to explore whether neck circumference can serve as an early predictor of the risk of Gestational Diabetes (GDM).
A total of 318 singleton pregnant women who underwent routine prenatal examinations at Qinhuangdao Maternal and Child Health Hospital from September 2017 to September 2020 were selected and categorized into the GDM group and the normal glucose tolerance group (NGT) based on the results of the oral glucose tolerance test (OGTT) conducted during the second trimester. The general information and laboratory test results were compared and analyzed. Inter-group comparison was conducted using the -test, and multivariate logistic regression analysis was employed to analyze the independent risk factors of GDM. The predictive threshold of various indicators for GDM occurrence during pregnancy was determined using the subject's work curve.
The GDM group exhibited significantly higher levels of pre-pregnancy weight, pre-pregnancy BMI, neck circumference, waist circumference, hip circumference, triglycerides (TG), uric acid (UA), TG/HDL-C ratio, and waist-hip ratio compared to the NGT group. Additionally, HDL cholesterol (HDL-C) levels were significantly lower in the GDM group, and blood glucose levels at each point of the OGTT were markedly higher compared to the NGT group (P<0.05). Multivariate logistic regression analysis revealed that neck circumference (OR=1.239, P<0.001) and early pregnancy TG (OR=1.842, P<0.001) were independent risk factors for GDM. The receiver operating characteristic analysis demonstrated that the optimal critical value of neck circumference for predicting GDM was 32.6 cm, with a sensitivity of 50% and specificity of 74.3%.
The neck circumference during early pregnancy was found to be related to GDM, and the predictive cutoff point of 32.6 cm for neck circumference could be employed as a simple index to predict GDM in early pregnancy.
本研究的目的是探讨颈围是否可作为妊娠期糖尿病(GDM)风险的早期预测指标。
选取2017年9月至2020年9月在秦皇岛市妇幼保健院进行常规产前检查的318名单胎孕妇,根据孕中期口服葡萄糖耐量试验(OGTT)结果分为GDM组和正常糖耐量组(NGT)。比较并分析一般资料和实验室检查结果。组间比较采用t检验,多因素logistic回归分析GDM的独立危险因素。利用受试者工作曲线确定孕期GDM发生的各项指标预测阈值。
与NGT组相比,GDM组孕前体重、孕前BMI、颈围、腰围、臀围、甘油三酯(TG)、尿酸(UA)、TG/HDL-C比值和腰臀比显著更高。此外,GDM组高密度脂蛋白胆固醇(HDL-C)水平显著更低,OGTT各点血糖水平均显著高于NGT组(P<0.05)。多因素logistic回归分析显示,颈围(OR=1.239,P<0.001)和孕早期TG(OR=1.842,P<0.001)是GDM的独立危险因素。受试者工作特征分析表明,预测GDM的颈围最佳临界值为32.6 cm,灵敏度为50%,特异度为74.3%。
发现孕早期颈围与GDM有关,颈围32.6 cm的预测切点可作为孕早期预测GDM的一个简单指标。