[1]许 航,贺 丹,罗 晴.育龄妇女年龄、孕前BMI和孕早期空腹血糖水平分布在妊娠期糖尿病预测中的价值[J].现代检验医学杂志,2021,36(05):169-173.[doi:10.3969/j.issn.1671-7414.2021.05.037]
 XU Hang,HE Dan,LUO Qing.Value of Age, Pre-Pregnancy Body Mass Index and Fasting Blood Glucose inEarly Pregnancy in Predicting Gestational Diabetes Mellitusamong Fertile Women[J].Journal of Modern Laboratory Medicine,2021,36(05):169-173.[doi:10.3969/j.issn.1671-7414.2021.05.037]
点击复制

育龄妇女年龄、孕前BMI和孕早期空腹血糖水平分布在妊娠期糖尿病预测中的价值()
分享到:

《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年05期
页码:
169-173
栏目:
检验与临床
出版日期:
2021-10-14

文章信息/Info

Title:
Value of Age, Pre-Pregnancy Body Mass Index and Fasting Blood Glucose inEarly Pregnancy in Predicting Gestational Diabetes Mellitusamong Fertile Women
文章编号:
1671-7414(2021)05-169-05
作者:
许 航贺 丹罗 晴
(宜宾市妇产儿童医院检验科,四川宜宾644000)
Author(s):
XU Hang HE Dan LUO Qing
(Department of Olinical Laboratory, Yibin Maternity and Children’s Hospital, Sichuan Yibin 644000,China)
关键词:
妊娠期糖尿病空腹血糖体质指数年龄
分类号:
R714.256;R446.11
DOI:
10.3969/j.issn.1671-7414.2021.05.037
文献标志码:
A
摘要:
目的 探讨育龄妇女年龄、孕前体质指数(BMI)和孕早期空腹血糖(FBG)在预测妊娠期糖尿病(GDM)中的价值。方法 随机抽取2018年1月~2019年12月于宜宾市妇产儿童医院规律孕期保健的孕妇1 263例,根据身高体重计算BMI,于孕13周以前采用己糖激酶法测定孕早期FBG,孕24~28周采用75g 口服葡萄糖耐量试验(OGTT)诊断GDM,了解孕早期FBG和GDM发病情况,用受试者工作曲线(ROC)探讨年龄、BMI和孕早期FBG在GDM预测中的价值。结果 孕早期空腹血糖平均为4.55±0.59mmol/L,不同年龄段、BMI和胎次孕妇的孕早期FBG值和FBG区段差异均有统计学意义(t/F/χ2=3.18~58.360,P<0.05)。妊娠24~28周共诊断出GDM患者192例,发病率15.20%,≥30岁组高于<30岁组(22.45% vs 11.43%),≥24 kg/m2组高于18.5~23.9 kg/m2及<18.5 kg/m2组(22.64% vs 12.95% vs 9.23%,差异有统计学意义(χ2=18.899,P<0.05)。孕早期不同FBG区段(<4.20,4.20~4.59,4.60~4.99,5.00~5.39和≥5.40 mmol/L)的孕妇GDM发病率分别为9.14%,11.59%,19.17%,30.69%和35.82%,差异有统计学意义(P<0.05)。GDM组和非GDM组孕早期FBG,年龄和BMI差异有统计学意义(t=11.645,8.657,5.861,均P<0.01)。孕早期FBG,年龄和BMI预测GDM的ROC曲线下面积分别为0.809,0.739和0.651,FBG,年龄和BMI的最佳切点值分别为4.59 mmol/L,26.5岁和22.05 kg/m2,此时灵敏度分别为79.2%,94.8%和68.2%,特异度分别为71.4%,50.5%和64.6%。结论 妊娠期糖尿病发病率较高,孕早期FBG,年龄和BMI与GDM发病有关,孕早期高FBG,高BMI和高龄会增加GDM风险。
Abstract:
Objective To discuss the value of age, pre-pregnancy body mass index (BMI) and fasting blood glucose (FBG) inearly pregnancy in predicting gestational diabetes mellitus (GDM) among fertile women. Methods From January 2018 toDecember 2019, 1 263 pregnant women had been selected from Yibin Maternity and Children’s Hospital. BMI was calculatedaccording to height and weight, FBG was measured by hexokinase method 13 weeks before pregnancy and GDM was diagnosedby oral glucose tolerance test (OGTT) of 75 in 24~ weeks of pregnancy. The incidence of FBG and GDM in early pregnancy wasunderstood. The value of age, BMI and FBG in GDM prediction was discussed by receiver operating characteristic (ROC).Results The average FBG in early pregnancy was 4.55±0.59 mmol/L with age, BMI and frequency of gravidity difference (t/F/χ2=3.18~58.360,all P<0.05). A total of 192 GDM gravidas was diagnosed in pregnancy 24 weeks to 28 weeks with incidenceat 15.20% by one-step method, incidence of over 30 years old higher than below 30 years old (22.45% vs 11.43%), BMI ≥ 24kg/m2 higher than 18.5~23.9 kg/m2 and <18.5 kg/m2 (22.64% vs 12.95% vs 9.23%),the difference were statisticallysignificant(χ2=18.899, P<0.05). Incidence of GDM in different FBG sections (<4.20, 4.20~4.59, 4.60~4.99, 5.00~5.39 and≥ 5.40 mmol/L) were 9.14%, 11.59%, 19.17%, 30.69 and 35.82% respectively with significant difference (P<0.05). There werestatistical difference of FBG in early pregnancy, age and BMI between GDM group and non-GDM group (t=11.645, 8.657,5.864, all P<0.01). The area under the curve (AUC) of FBG in early pregnancy, age and BMI for predicting GDM were 0.809,0.739 and 0.651 with best tangent point value 4.59 mmol/L, 26.5 years old and 22.05 kg/m2 respectively, the sensitivity of FBG,age and BMI for predicting GDM was 79.2%, 94.8% and 68.2%, the specificity was 71.4%, 50.5% and 64.6% respectively.Conclusion The incidence rate of gestational diabetes was high, FBG age and BMI in early pregnancy,were related to the on setof BMI, high FBG, BMI and advanced age in early pregnancy could increase the risk of GDM.

参考文献/References:

[1] 娜仁其木格, 李冬梅, 米林香, 等. 中国妊娠期糖尿病患病率的Meta 分析[J]. 中国循证医学杂志,2018,18(3):280-285.NA Renqimuge, LI Dongmei, MI Linxiang,et al.Prevalence rate of gestational diabetes mellitus inChina: a meta-analysis[J]. Chinese Journal of Evidence-Based Medicine,2018,18(3):280-285.
[2] 王晨, 杨慧霞. 早孕期空腹血糖对妊娠期糖尿病的预测价值[J]. 中华糖尿病杂志,2016,8(7):405-409.WANG Chen, YANG Huixia. Predictive value of earlypregnancy fasting blood glucose for development ofgestational diabetes mellitus[J]. Chinese Journal ofDiabetes Mellitus,2016,8(7):405-409.
[3] LEE K W, CHING S M, RAMACHANDRAN V, etal. Prevalence and risk factors of gestational diabetesmellitus in Asia: a systematic review and metaanalysis[J]. BMC Pregnancy and Childbirth, 2018,18(1): 494.
[4] SHANG Min, LIN Li. IADPSG criteria for diagnosinggestational diabetes mellitus and predicting adversepregnancy outcomes[J]. Journal of Perinatology, 2014,34(2): 100-104.
[5] Committee on Practice Bulletins-Obstetrics. ACOGpractice bulletin no. 190: gestational diabetesmellitus[J]. Obstetrics and Gynecology, 2018, 131(2):e49-e64.
[6] HOSSEINI E, JANGHORBANI M, AMINORROAYAA. Incidence, risk factors, and pregnancy outcomesof gestational diabetes mellitus using one-step versustwo-step diagnostic approaches: A population-basedcohort study in Isfahan, Iran[J]. Diabetes Research andClinical Practice, 2018, 140: 288-294.
[7] CAISSUTTI C, KHALIFEH A, SACCONE G, et al.Are women positive for the One Step but negative forthe Two Step screening tests for gestational diabetes athigher risk for adverse outcomes[J]. Acta Obstetricia etGynecologica Scandinavica, 2018, 97(2): 122-134.
[8] GAO Chenghan, SUN Xin, LU Li, et al. Prevalenceof gestational diabetes mellitus in mainland China:A systematic review and meta-analysis[J]. Journal ofDiabetes Investigation, 2019, 10(1): 154-162.
[9] ZHOU Shengtao, WANG Ming, ZHANG Li. Risk factorsfor gestational diabetes mellitus in the population of westernChina[J]. Epidemiology (sunnyvale), 2015, 5(2): 185.
[10] YERAL M I, ERDINC A, UYGUR D, e t a l .239:Prediction of gestational diabetes mellitus in thefirst trimester;comparion of fasting plasma glucose,twostepand one-step methods[J]. American Journalof Obstetrics and Gynecology, 2013, 208(suppl 1):S110-S111.
[11] 岑立微,肖晶晶,彭婷.孕8 ~ 15 周空腹血糖、红白细胞计数联合临床指标预测妊娠期糖尿病发生风险的临床价值[J]. 现代妇产科进展,2019,28(3):182-185,189.CHEN Liwei, XIAO Jingjing, PENG Ting. The clinicalvalue of fasting plasma glucose,red and white bloodcell cout combined clinical indicators between 8 and15 weeks of gestation in the prediction of gestationaldiabe-tes mellitus [J]. Progress in Obstetrics and Gynecology,2019,28(3):182-185,189.
[12] 李利平,姜宏卫,陈治珉,等.国际糖尿病妊娠研究组新诊断标准调查妊娠期糖尿病患病率及其危险因素分析[J]. 中国糖尿病杂志,2015,23(4):289-292.LI Liping, JIANG Hongwei, CHEN Zhimin,et al.Investigation of the prevalence rate of gestationaldiabetes mellitus with diagnostic criteria of IADPSGand the analysis of its risk factors[J]. Chinese Journalof Diabetes,2015,23(4):289-292.
[13] 杨帅,范建霞. 早孕期空腹血糖筛查对妊娠期糖尿病的预测作用[J]. 中国临床医生杂志,2017,45(6):9-11.YANG Shuai, FAN Jianxia.Predictive effect offasting blood glucose screening in early pregnancy ongestational diabetes mellitus[J]. Chinese Journal forClinicians,2017,45(6):9-11.
[14] BUFFARINI R, BARROS A, MATIJASEVICH A,et al. Gestational diabetes mellitus, pre-gestationalBMI and offspring BMI z-score during infancy andchildhood: 2004 Pelotas Birth Cohort[J]. BMJ Open,2019, 9(7): e024734.
[15] RISKIN-MASHIAH S, DAMTI A, YOUNES G, et al.First trimester fasting hyperglycemia as a predictor forthe development of gestational diabetes mellitus[J].European Journal of Obstetrics & Gynecology andReproductive Biology, 2010, 152(2):163-167.
[16] 李萍, 林硕, 范建辉, 等. 孕16~18 周空腹血糖对妊娠期糖尿病的预测价值[J]. 新医学, 2016,47(10):691-694.LI Ping, LIN Shuo, FAN Jianhui,et al. Measurement offasting plasma glucose at 16 ~ 18 weeks of gestationin predicting gestational diabetes mellitus [J]. NewMedicine, 2016,47(10):691-694.
[17] 杨丽, 范玲. 妊娠早期空腹血浆葡萄糖水平与妊娠期糖尿病的相关性[J]. 中华围产医学杂志,2014,17(2):88-92.YANG Li, FAN Ling. Correlations between fastingplasma glucose level in the first trimester andgestational diabetes mellitus[J]. Chinese Journal ofPerinatal Medicine ,2014,17(2):88-92.
[18] 姜艳, 李光辉, 刘晓巍. 孕妇年龄及孕早期空腹血糖水平在预测妊娠期糖尿病发病中的临床价值研究[J]. 中国实用妇科与产科杂志,2018,34(2):176-180.JIANG Yan, LI Guanghui, LIU Xiaowei. Value ofmaternal age and fasting blood glucose levels of earlypregnancy in prediction of gestational diabetes mellitus[J]. Chinese Journal of Practical Gynecology andObstetrics,2018,34(2):176-180.
[19] 石志宜, 顾平, 赵青茹, 等. 孕早期空腹血糖联合体重指数预测妊娠期糖尿病发生风险的临床价值[J].护理研究, 2018,32(21):3422-3425.SHI Zhiyi, GU Ping, ZHAO Qingru, et al. Clinicalvalue of fasting blood glucose combined with bodymass index in predicting risk of gestational diabetesmellitus in early pregnancy [J]. Chinese NursingResearch, 2018,32(21):3422-3425.
[20] 马合红, 宋莉莉, 王佩, 等. 孕早期血清和肽素联合空腹血糖在妊娠期糖尿病诊断中的价值分析[J].现代预防医学,2019,46(17):3139-3142,3156.MA Hehong, SONG Lili, WANG Pei,et al. Diagnosisvalue of serum and copeptin level combinedwith fasting blood glucose of gestational diabetesin early pregnancy [J]. Modern Preventive Medicine,2019,46(17):3139-3142,3156.
[21] 韩文莉.孕早期空腹血糖对妊娠期糖尿病的预测价值[J].实用妇产科杂志,2020,36(3):200-203.HAN Wenli. Predictive value of fasting bloodglucose in early pregnancy for gestational diabetesmellitus[J]. Journal of Practical Obstetrics andGynecology,2020,36(3):200-203.
[22] 梁培松, 王结珍, 陈康, 等. 孕早期年龄,BMI 和PAPPA 水平综合评价对GDM 的预测价值[J]. 现代检验医学杂志, 2020,35(1):133-135.LIANG Peisong, WANG Jiezhen, CHEN Kang,etal. Predictive value of comprehensive evaluation ofearly pregnant age, BMI and PAPPA levels to theGDM [J]. Journal of Modern Laboratory Medicine,2020,35(1):133-135.

相似文献/References:

[1]高 飞,杨红玲,王洁琳,等.妊娠期糖尿病患者红细胞分布宽度与胰岛素抵抗的相关性研究[J].现代检验医学杂志,2017,32(01):66.[doi:10.3969/j.issn.1671-7414.2017.01.018]
 GAO Fei,YANG Hong-ling,WANG Jie-lin,et al.Relationship between the Red Cell Volume Distribution Width in Patients with Gestational Diabetes and Insulin Resistance[J].Journal of Modern Laboratory Medicine,2017,32(05):66.[doi:10.3969/j.issn.1671-7414.2017.01.018]
[2]乔国昱,何亚萍,周 洁.妊娠期糖尿病并发甲状腺功能减退孕妇凝血功能指标的变化研究[J].现代检验医学杂志,2017,32(03):109.[doi:10.3969/j.issn.1671-7414.2017.03.029]
 QIAO Guo-yu,HE Ya-ping,ZHOU Jie.Study on the Alteration of Blood Coagulation Function of PregnantWomen with Pothyroidism Companied with Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2017,32(05):109.[doi:10.3969/j.issn.1671-7414.2017.03.029]
[3]肖鸽飞,李 桦,孟小军,等.孕妇FTO基因的表达与胰岛素水平相关性的研究[J].现代检验医学杂志,2017,32(05):44.[doi:10.3969/j.issn.1671-7414.2017.05.012]
 XIAO Ge-fei,LI Hua,MENG Xiao-jun,et al.Correlation Study on FTO Expression and Insulin Secretion Level in Pregnant Women[J].Journal of Modern Laboratory Medicine,2017,32(05):44.[doi:10.3969/j.issn.1671-7414.2017.05.012]
[4]刘 然.体质指数与血清C反应蛋白和糖化血红蛋白在妊娠期糖尿病诊断中的意义[J].现代检验医学杂志,2018,33(05):49.[doi:10.3969/j.issn.1671-7414.2018.05.014]
 LIU Ran.Diagnostic Significance of BMI,Serum CRP and HbA1c in Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2018,33(05):49.[doi:10.3969/j.issn.1671-7414.2018.05.014]
[5]季雄娟,邵 静,陆 胜.糖化血红蛋白及糖化清蛋白水平对糖尿病视网膜病变的诊断价值分析[J].现代检验医学杂志,2018,33(05):77.[doi:10.3969/j.issn.1671-7414.2018.05.021]
 JI Xiong-juan,SHAO Jing,LU Sheng.Diagnostic Value of Glycocsylated Hemoglobin A1c and Glycated Albumin Levels in Diabetic Retinopany[J].Journal of Modern Laboratory Medicine,2018,33(05):77.[doi:10.3969/j.issn.1671-7414.2018.05.021]
[6]张震英,田春雨,赵乐,等.血清FPG 及HbA1c 水平检测对2 型糖尿病继发干眼症的预测价值研究及危险因素分析[J].现代检验医学杂志,2020,35(05):68.[doi:10.3969/j.issn.1671-7414.2020.05.018]
 ZHANG Zhen-ying,TIAN Chun-yu,ZHAO Le,et al.Study on the Predictive Value of Serum FPG and HbA1c Level in Dry Eye Secondary to Type 2 Diabetes Mellitus and Analysis of Risk Factors[J].Journal of Modern Laboratory Medicine,2020,35(05):68.[doi:10.3969/j.issn.1671-7414.2020.05.018]
[7]陈丽华a,王思思b,朱婕曼a,等.高龄产妇孕中期血清 FPG,HbA1c 及 TC 联合检测预测 GDM 风险的临床研究[J].现代检验医学杂志,2020,35(06):33.[doi:doi:10.3969/j.issn.1671-7414.2020.06.009]
 CHEN Li-hua a,WANGg Si-si b,ZHU Jie-man a,et al.Clinical Study on Prediction of GDM Risk by Combined Detection of SerumFPG, HbA1c and TC in the Second Trimester of Pregnancy in Elderly Women[J].Journal of Modern Laboratory Medicine,2020,35(05):33.[doi:doi:10.3969/j.issn.1671-7414.2020.06.009]
[8]孙 红,付翠芳,高佳丽,等.妊娠期糖尿病患者血清miR-21,PPARγ和IGF-1R表达水平与凝血功能和妊娠结局的相关性研究[J].现代检验医学杂志,2021,36(05):143.[doi:10.3969/j.issn.1671-7414.2021.05.032]
 SUN Hong,FU Cui-fang,GAO Jia-li,et al.Study on the Correlation between Serum miR-21, PPAR γ and IGF-1R Expression Levels in Patients with Gestational Diabetes and BloodCoagulation Function and Pregnancy Outcome[J].Journal of Modern Laboratory Medicine,2021,36(05):143.[doi:10.3969/j.issn.1671-7414.2021.05.032]
[9]徐 燕,李 晶.孕早期妇女血清人吻素、网膜素-1和Lipasin水平检测对早期预测妊娠期糖尿病发生风险的价值[J].现代检验医学杂志,2022,37(03):119.[doi:10.3969/j.issn.1671-7414.2022.03.025]
 XU Yan,LI Jing.Value of Serum Human Kisspeptin, Omentin-1 and Lipasin Levels in Early Pregnant Women for Early Prediction of the Risk of Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2022,37(05):119.[doi:10.3969/j.issn.1671-7414.2022.03.025]
[10]周 青,秦智娟,马宗丽.妊娠期糖尿病患者血清miR-450a-5p 和CREB 表达水平及临床意义[J].现代检验医学杂志,2022,37(04):102.[doi:10.3969/j.issn.1671-7414.2022.04.020]
 ZHOU Qing,QIN Zhi-juan,MA Zong-li.Expression Levels and Clinical Significance of Serum miR-450a-5p and CREB in Patients with Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2022,37(05):102.[doi:10.3969/j.issn.1671-7414.2022.04.020]

备注/Memo

备注/Memo:
基金项目:宜宾市科技局项目(2018KF009),宜宾市卫生健康委项目(2019003)。
作者简介:许航(1982-),女,硕士,副主任技师,主要从事临床检验工作,E-mail:huaxi19793@126.com。
更新日期/Last Update: 1900-01-01