Xinjiang Medical University, Urumqi, China.
Department of Gynecology and Obstetrics, The First People's Hospital of Shuangliu District, Chengdu, China.
J Obstet Gynaecol. 2024 Dec;44(1):2372665. doi: 10.1080/01443615.2024.2372665. Epub 2024 Jul 4.
Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication during pregnancy. We aimed to evaluate a risk prediction model of GDM based on traditional and genetic factors.
A total of 2744 eligible pregnant women were included. Face-to-face questionnaire surveys were conducted to gather general data. Serum test results were collected from the laboratory information system. Independent risk factors for GDM were identified using univariate and multivariate logistic regression analyses. A GDM risk prediction model was constructed and evaluated with the Hosmer-Lemeshow goodness-of-fit test, goodness-of-fit calibration plot, receiver operating characteristic curve and area under the curve.
Among traditional factors, age ≥30 years, family history, GDM history, impaired glucose tolerance history, systolic blood pressure ≥116.22 mmHg, diastolic blood pressure ≥74.52 mmHg, fasting plasma glucose ≥5.0 mmol/L, 1-hour postprandial blood glucose ≥8.8 mmol/L, 2-h postprandial blood glucose ≥7.9 mmol/L, total cholesterol ≥4.50 mmol/L, low-density lipoprotein ≥2.09 mmol/L and insulin ≥11.5 mIU/L were independent risk factors for GDM. Among genetic factors, 11 single nucleotide polymorphisms (SNPs) (rs2779116, rs5215, rs11605924, rs7072268, rs7172432, rs10811661, rs2191349, rs10830963, rs174550, rs13266634 and rs11071657) were identified as potential predictors of the risk of postpartum DM among women with GDM history, collectively accounting for 3.6% of the genetic risk.
Both genetic and traditional factors contribute to the risk of GDM in women, operating through diverse mechanisms. Strengthening the risk prediction of SNPs for postpartum DM among women with GDM history is crucial for maternal and child health protection.
妊娠糖尿病(GDM)是一种常见的妊娠并发症。我们旨在评估基于传统和遗传因素的 GDM 风险预测模型。
共纳入 2744 名符合条件的孕妇。通过面对面问卷调查收集一般资料。从实验室信息系统中收集血清检测结果。使用单因素和多因素逻辑回归分析确定 GDM 的独立危险因素。构建 GDM 风险预测模型,并通过 Hosmer-Lemeshow 拟合优度检验、拟合优度校准图、受试者工作特征曲线和曲线下面积进行评估。
在传统因素中,年龄≥30 岁、家族史、GDM 史、糖耐量受损史、收缩压≥116.22mmHg、舒张压≥74.52mmHg、空腹血糖≥5.0mmol/L、餐后 1 小时血糖≥8.8mmol/L、餐后 2 小时血糖≥7.9mmol/L、总胆固醇≥4.50mmol/L、低密度脂蛋白≥2.09mmol/L、胰岛素≥11.5mIU/L 是 GDM 的独立危险因素。在遗传因素中,鉴定出 11 个单核苷酸多态性(SNP)(rs2779116、rs5215、rs11605924、rs7072268、rs7172432、rs10811661、rs2191349、rs10830963、rs174550、rs13266634 和 rs11071657)为 GDM 病史女性产后糖尿病风险的潜在预测因子,共同占遗传风险的 3.6%。
遗传和传统因素均会增加 GDM 女性的患病风险,其作用机制各不相同。加强对 GDM 病史女性产后糖尿病 SNP 风险的预测,对母婴健康保护至关重要。