Heyl W, Schröder W, Kitschke H J
Frauenklinik, RWTH-Aachen.
Zentralbl Gynakol. 1995;117(5):269-73.
Postpartal screening of undetected gestational diabetes has proven to be difficult. Rapid decrease in diabetogenic hormones and normalisation of the former delayed insulin-response make it difficult to detect disturbed glucose tolerance in the puerperium. Therefore, glycolysated serum proteins offer the opportunity for retrospective diagnosis. They allow an evaluation of the patient's carbohydrate metabolism, retrospectively over several weeks. In this context, we were most interested in the significance of fructosamine. In a prospective study covering 12 months, 123 patients with several risk factors for gestational diabetes underwent a 100 g glucose tolerance test in the puerperium. Furthermore, we measured fructosamine and glycolysated hemoglobin. A carbohydrate intolerance could be detected by the oral glucose tolerance test in 22.7%. In 12.2% of the cases, glycolysated hemoglobin was found to be higher than 5.5%. Fructosamine levels were normal for all patients, with a mean value of 1.84 mmol/l. Even though fructosamine concentration was significantly higher (p < 0.05) in patients with a pathologic glucose tolerance, our study showed the oral glucose tolerance test to be better to detect unknown gestational diabetes than measurement of serum fructosamine.
产后筛查未被发现的妊娠期糖尿病已被证明是困难的。致糖尿病激素的快速下降以及前者延迟胰岛素反应的正常化使得在产褥期难以检测到糖耐量异常。因此，糖化血清蛋白为回顾性诊断提供了机会。它们可以回顾性地评估患者数周内的碳水化合物代谢情况。在这种情况下，我们对果糖胺的意义最为关注。在一项为期12个月的前瞻性研究中，123例有妊娠期糖尿病多种危险因素的患者在产褥期接受了100克葡萄糖耐量试验。此外，我们还测量了果糖胺和糖化血红蛋白。通过口服葡萄糖耐量试验可检测出22.7%的碳水化合物不耐受情况。在12.2%的病例中，发现糖化血红蛋白高于5.5%。所有患者的果糖胺水平均正常，平均值为1.84毫摩尔/升。尽管糖耐量异常患者的果糖胺浓度显著更高（p<0.05），但我们的研究表明，口服葡萄糖耐量试验在检测未知妊娠期糖尿病方面比检测血清果糖胺更好。
