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孕早期母体脂肪组织测量对妊娠期糖尿病预测的有效性:一项前瞻性队列研究。

Effectiveness of first trimester maternal fat tissue measurement in prediction of gestational diabetes: a prospective cohort study.

作者信息

Emeklioğlu Cağdaş Nurettin, Acar Şirinoğlu Hicran, Özalp Miraç, Eren Melike, Akkoç Demirel Elif, Genç Simten, Mihmanlı Veli

机构信息

Clinic of Obstetrics and Gynecology, Karabük University Training and Research Hospital, Karabük, Turkey

Clinic of Obstetrics and Gynecology, Unit of Perinatology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey

出版信息

J Turk Ger Gynecol Assoc. 2024 Dec 10;25(4):224-230. doi: 10.4274/jtgga.galenos.2023.2023-4-6. Epub 2024 Sep 10.

Abstract

OBJECTIVE

The aim was to find a cost-effective, more practical method to be used in the early gestational weeks as an alternative to the oral glucose tolerance test (OGTT) for predicting gestational diabetes mellitus (GDM). The method selected was adipose tissue measurements made in the first trimester.

MATERIAL AND METHODS

The study was designed as a prospective, cohort study. Ultrasound images were used to calculate abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) thicknesses of the first trimester pregnant women. Two groups were formed: those who were diagnosed with GDM and those who were not, based on the results of the OGTT performed in the same patients at 24-28 weeks of gestation. Ultrasonographic records were examined and compared between these two groups using received operator characteristic curves and logistic regression analyses.

RESULTS

A total of 292 pregnant women were included, of whom 21.2% were diagnosed with GDM. In the group diagnosed with GDM, SAT, VAT and total adipose tissue (TAT) values were significantly higher than the women who did not have GDM. Threshold values for SAT, VAT and TAT were 18 mm, 55 mm and 55 mm.

CONCLUSION

First trimester SAT, VAT and TAT measurements of pregnant women with GDM were significantly higher than those without GDM diagnosis. Although our results showed that adipose measurements cannot be an alternative to OGTT; they may be a powerful aid in identify at-risk pregnant women, suggesting to perform an early OGTT in the first trimester.

摘要

目的

旨在找到一种经济高效且更实用的方法,在孕早期替代口服葡萄糖耐量试验(OGTT)来预测妊娠期糖尿病(GDM)。所选用的方法是孕早期的脂肪组织测量。

材料与方法

本研究设计为前瞻性队列研究。利用超声图像计算孕早期孕妇的腹部内脏脂肪(VAT)和皮下脂肪组织(SAT)厚度。根据同一批患者在妊娠24 - 28周时进行的OGTT结果,将其分为两组:被诊断为GDM的患者和未被诊断为GDM的患者。使用接受者操作特征曲线和逻辑回归分析对这两组的超声记录进行检查和比较。

结果

共纳入292名孕妇,其中21.2%被诊断为GDM。在被诊断为GDM的组中,SAT、VAT和总脂肪组织(TAT)值显著高于未患GDM的女性。SAT、VAT和TAT的阈值分别为18毫米、55毫米和55毫米。

结论

GDM孕妇孕早期的SAT、VAT和TAT测量值显著高于未被诊断为GDM的孕妇。尽管我们的结果表明脂肪测量不能替代OGTT;但它们可能有助于识别高危孕妇,建议在孕早期进行早期OGTT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3521/11632638/379ca426eb8e/JTurkGerGynecolAssoc-25-224-figure-1.jpg

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