中孕早期血清糖化白蛋白和性激素结合球蛋白水平与妊娠期糖尿病的相关性

Correlation between gestational diabetes mellitus,serum levels of glycated albumin and sex hormone binding globulin in the early period of the second trimester

目的探讨中孕早期血清糖化白蛋白(GA)和性激素结合球蛋白(SHBG)水平与妊娠期糖尿病(GDM)的关系。方法选择孕15周~20周GDM孕妇和对照组孕妇各150例,测定2组的GA和SHBG水平,并进行统计学分析。结果GDM组血清GA水平高于对照组,而SHBG水平低于对照组,差异均有统计学意义(P<0.01)。GA、SHBG与继发GDM显著相关(P<0.05)。GA每升高1.0%,发生GDM的风险增加2.489倍;SHBG每升高50 nmol/L,发生GDM的危险下降51%。联合GA、SHBG预测GDM的敏感度(91.3%)高于GA(66.0%)、SHBG(83.3%)单独检测,差异有统计学意义(P<0.05)。结论中孕早期GA和SHBG的联合检测能提高对GDM的预测效率,当GA≥13.85%或SHBG≤100.8 nmol/L时,有评估发生GDM风险的价值,值得临床重视。

Objective To investigate the correlation between gestational diabetes mellitus（ GDM）,serum levels of glycated albumin（ GA） and sex hormone binding globulin（ SHBG） in the early period of the second trimester. Methods A total of 150 GDM pregnant women and another 150 control pregnant women with gestational ages of 15-20 weeks were selected,and the serum levels of GA and SHBG were determined and statistically analyzed. Results GDM group had a significantly higher serum GA level and a significantly lower serum SHBG level than the control group,with the differences statistically significant（ P 0. 01）. GA and SHBG were significantly correlated with secondary GDM（ P 0. 05）. Following a GA increase by each 1. 0%,the risk for GDM increased by 2. 489 times; and following a SHBG increase by each 50 nmol/L,the risk for GDM decreased by51%. GA combined with SHBG（ 91. 3 %） in prediction of GDM had a significantly higher sensitivity than single GA（ 66. 0 %）and single SHBG（ 83. 3 %）,with the differences statistically significant（ P 0. 05）. Conclusion In the early period of the second trimester,determining GA combined with SHBG can elevate the GDM predictive efficiency. When GA was ≥13. 85%or SHBG was ≤100. 8 nmol/L,it is valuable for evaluating GDM risks and worthy of clinical attention.