中国全科医学2018，Vol.21Issue(10)：1216-1220,5.DOI:10.3969/j.issn.1007-9572.2018.10.015
妊娠早期妊娠期糖尿病相关预测指标的研究
Predictors of Gestational Diabetes Mellitus during the First Trimester of Pregnancy
摘要
Abstract
Objective To explore the predictors for gestational diabetes mellitus (GDM) during the first trimester of pregnancy.Methods 192 pregnant women who received the services included in the Heahhcare Handbook for Pregnant Women in Wenzhou People's Hospital from July 2013 to October 2014 were enrolled.According to the results of OGTT performed between 24 and 28 gestational weeks,they were equally divided into GDM and non-GDM groups (GDM was defined based on the latest diagnostic criteria).Both groups' demographic data,levels of serum ferritin,fasting plasma glucose (FPG),fasting insulin (FINS),C-peptide,hemoglobin (Hb) and glycosylated hemoglobin (HbA1c) measured between 8 and 14 gestational weeks and calculated homeostasis model assessment-insulin resistance index (HOMA-IR) were collected and compared.Logistic regression analysis was performed to investigate the factors associated with GDM.And ROC curve analysis was conducted to examine the value of both HbA1c and HOMA-IR for predicting GDM.Results There were no significant differences in age,parity,gravidity,height,weight,levels of BMI,SF,and FPG between the groups (P＞0.05).GDM group demonstrated higher levels of FINS,C-peptide,Hb,HbA1c,and HOMA-IR compared with non-GDM group (P＜0.05).As showed by Logistic regression analysis that HbA1c and HOMA-IR were two factors associated with GDM in the first trimester of pregnancy.For predicting GDM,the AUC of HbA1c was 0.642 [95％CI (0.565,0.719)],and the optimal cut off point was 5.15％,corresponding sensitivity and specificity were 46.9％ and 71.9％,respectively;the AUC of HOMA-IR was 0.616 [95％CI (0.536,0.696)],and the optimal cut off point was 1.07,corresponding sensitivity and specificity were 65.6％ and 57.3％,respectively;the AUC of HbA1c combined with HOMA-IR was 0.695 [95％CI (0.622,0.769).Conclusion HbA1c and HOMA-IR may predict the occurrence of GDM at the first trimester of pregnancy.关键词
糖尿病,妊娠/血红蛋白A,糖基化/受试者工作曲线/预测Key words
Diabetes, gestational/Hemoglobin A, glycosylated/ROC curve/Forecasting分类
医药卫生引用本文复制引用
郑小冬,杨洁,胡仙清,周庆调,凌思思..妊娠早期妊娠期糖尿病相关预测指标的研究[J].中国全科医学,2018,21(10):1216-1220,5.基金项目
温州市科技局计划项目(Y20130357) （Y20130357）
