Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China.
Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China.
J Diabetes Investig. 2024 Oct;15(10):1489-1499. doi: 10.1111/jdi.14269. Epub 2024 Jul 15.
AIMS/INTRODUCTION: Women with gestational diabetes mellitus are at high risk for adverse maternal and neonatal outcomes. The study aimed to evaluate the performance of the triglyceride-glucose index in predicting the risk of developing adverse outcomes in women with gestational diabetes mellitus.
This retrospective multicenter cohort study included 8,808 pregnant women with gestational diabetes mellitus in two grade-A tertiary hospitals in China during 2018-2022. The triglyceride-glucose index was defined as ln [triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. Significant adverse gestational diabetes mellitus outcomes were chosen by generalized linear models as the main outcomes. Multivariable logistic regression models evaluated their association with the triglyceride-glucose index. Areas under the receiver operating characteristic curves predicted adverse pregnancy outcomes. The prediction efficiency was validated in the sensitivity analysis dataset and validation cohort.
The triglyceride-glucose index was associated with preeclampsia, severe preeclampsia, preterm birth, placenta accreta spectrum, and macrosomia before and after adjusting for confounding factors (P < 0.05). The predictive performance of the triglyceride-glucose index was relatively moderate. Incorporating the triglyceride-glucose index into the baseline clinical risk model improved the area under curves for the diagnosis of preeclampsia (0.749 [0.714-0.784] vs 0.766 [0.734-0.798], P = 0.033) and macrosomia (0.664 [0.644-0.685] vs 0.676 [0.656-0.697], P = 0.002). These predictive models exhibited good calibration and robustness.
The triglyceride-glucose index is positively associated with preeclampsia, severe preeclampsia, preterm birth, placenta accreta spectrum, and macrosomia and is useful for the early prediction and prevention of adverse outcomes in women with gestational diabetes mellitus.
目的/引言：患有妊娠糖尿病的女性存在发生不良母婴结局的高风险。本研究旨在评估甘油三酯-葡萄糖指数在预测妊娠糖尿病女性发生不良结局风险中的表现。
本回顾性多中心队列研究纳入了 2018 年至 2022 年期间中国两家甲级三级医院的 8808 例妊娠糖尿病孕妇。甘油三酯-葡萄糖指数定义为 ln[甘油三酯(mg/dL)×空腹血糖(mg/dL)/2]。广义线性模型选择显著的不良妊娠糖尿病结局作为主要结局。多变量逻辑回归模型评估了它们与甘油三酯-葡萄糖指数的关系。接受者操作特征曲线下的面积预测不良妊娠结局。在敏感性分析数据集和验证队列中验证了预测效率。
甘油三酯-葡萄糖指数与子痫前期、重度子痫前期、早产、胎盘植入综合征和巨大儿有关，在调整混杂因素前后均有统计学意义（P<0.05）。甘油三酯-葡萄糖指数的预测性能相对适中。将甘油三酯-葡萄糖指数纳入基线临床风险模型可提高子痫前期（0.749[0.714-0.784]比 0.766[0.734-0.798]，P=0.033）和巨大儿（0.664[0.644-0.685]比 0.676[0.656-0.697]，P=0.002）的诊断曲线下面积。这些预测模型具有良好的校准和稳健性。
甘油三酯-葡萄糖指数与子痫前期、重度子痫前期、早产、胎盘植入综合征和巨大儿呈正相关，可用于预测和预防妊娠糖尿病女性的不良结局。
