Rajeevan Jayarajah, Sritharan Apputhurai
Obstetrics and Gynaecology, Jaffna Teaching Hospital, Jaffna, LKA.
Cureus. 2024 Apr 14;16(4):e58245. doi: 10.7759/cureus.58245. eCollection 2024 Apr.
Gestational diabetes mellitus's (GDM's) prevalence in Sri Lanka ranges from 5.5% to 11.5%. It is associated with maternal and perinatal complications, emphasizing the need for early screening and intervention. This study aims to determine the predictive effect of early pregnancy lipid profile and fasting plasma glucose for GDM.
It is a prospective cohort study of 172 pregnant women attending antenatal clinics at a tertiary hospital in Jaffna, Sri Lanka. Prediction was derived by calculating odds ratios (ORs) and 95% confidence intervals (CIs) in multivariable logistic regression, assessing lipid and glucose effects on GDM risk.
The study included 172 participants (mean age: 29.84±5.38). GDM's prevalence was 16.9%, and 57.14% of these mothers were obese. Significant differences in fasting plasma glucose (FPG) values were observed between the first visit and at 24-28 weeks. GDM mothers showed elevated total cholesterol and low-density lipoprotein (LDL) levels. Triglyceride (TG) levels correlated significantly with FPG at the Point of Assessment (POA), identifying a 0.945 mmol/L cutoff with 75% sensitivity and 77.1% specificity. Logistic regression confirmed a significant TG-GDM relationship. There is an association between FPG levels measured in early pregnancy and the likelihood of developing GDM later on. Specifically, when FPG levels in early pregnancy surpass a cutoff value of 3.94 mmol/L, there is an increased risk of GDM, indicated by an OR of 3.81 Conclusion: Early pregnancy FPG and TG levels are potential markers for predicting GDM. FPG shows higher predictive efficacy than TG. Total cholesterol, LDL, and high-density lipoprotein (HDL) lack predictive ability.
斯里兰卡妊娠期糖尿病（GDM）的患病率在5.5%至11.5%之间。它与孕产妇和围产期并发症相关，这突出了早期筛查和干预的必要性。本研究旨在确定孕早期血脂谱和空腹血糖对GDM的预测作用。
这是一项对斯里兰卡贾夫纳一家三级医院产前诊所的172名孕妇进行的前瞻性队列研究。通过多变量逻辑回归计算比值比（OR）和95%置信区间（CI）来进行预测，评估血脂和血糖对GDM风险的影响。
该研究纳入了172名参与者（平均年龄：29.84±5.38）。GDM的患病率为16.9%，其中57.14%的母亲肥胖。在首次就诊时和孕24 - 28周时观察到空腹血糖（FPG）值存在显著差异。GDM母亲的总胆固醇和低密度脂蛋白（LDL）水平升高。甘油三酯（TG）水平在评估点（POA）与FPG显著相关，确定了一个截断值为0.945 mmol/L，敏感性为75%，特异性为77.1%。逻辑回归证实了TG与GDM之间存在显著关系。孕早期测量的FPG水平与后期发生GDM的可能性之间存在关联。具体而言，当孕早期FPG水平超过3.94 mmol/L的截断值时，GDM风险增加，OR为3.81。结论：孕早期FPG和TG水平是预测GDM的潜在标志物。FPG显示出比TG更高的预测效力。总胆固醇、LDL和高密度脂蛋白（HDL）缺乏预测能力。
