BMI,hs-CRP和Hb A1c水平对妊娠糖尿病早期诊断的价值分析

The specificity and sensitivity of BMI,hs-crp and Hb A1c levels in early diagnosis of gestational diabetes

目的研究体质指数(BMI)、糖化血红蛋白(HbA1c)及超敏C反应蛋白(hs-CPR)水平测定对妊娠期糖尿病(GDM)早期诊断的特异性和敏感性。方法对2016年-2017年来我院建档分娩的200例妊娠糖尿病患者和200例正常孕妇孕10-14周体质指数(BMI)、糖化血红蛋白(HbA1c)及超敏C反应蛋白(hs-CPR)检测结果和孕24-28周葡萄糖耐量(OGTT)试验结果进行统计学分析,研究上述指标与妊娠糖尿病发病之间的相关性以及用于早期诊断妊娠糖尿病的特异性和敏感性。结果观察组在孕10-14周时BMI,Hb A1c和hs-CRP均值分别为(23.1±2.12)(kg/m2),(9.7±2.6)(%),(3.6±1.2)(mg/L),高于对照组的(20.3±1.98)(kg/m2),(5.8±2.0)(%),(2.1±1.1)(mg/L),差异均有统计学意义(P<0.01);观察组BMI,hs-CRP和Hb A1三项指标异常率分别为34.5%,77%,60.5%,显著高于对照组的21.0%,18.5%,23.5%,差异均有统计学意义(P<0.01);BMI、HbA1c及hs-CRP三项指标对于妊娠糖尿病早期诊断均有较高的特异性和敏感性。结论孕早期BMI,Hb A1c和hs-CRP的检测结果与妊娠糖尿病发病具有相关性,对妊娠糖尿病有重要的临床预测意义。

Objective To investigate the evaluate the feasibility of of body mass index,glycosylated hemoglobin and ultra sensitive C-protein in screening gestational diabetes mellitus.Methods 200 pregnant women with gestational diabetes mellitus and 200 healthy pregnant women selected as observation group and control group respectively who were admitted in our hospital from January 2016 to June 2017,tested the body mass index,glycosylated hemoglobin（HbA1 c）and hs-CRP level during 10-14 pregnant weeks,and the glucose tolerance test（OGTT）during 24-28 pregnant weeks,and evaluated the specificity and positive predictive value of diagnostic indexes.Results BMI,HbA1 cand hs-CRP levels of the observation group were（23.1±2.12）（kg/m2）,（9.7±2.6）（%）,（3.6±1.2）（mg/L）,which was significantly higher than those in the control group（20.3±1.98）（kg/m2）,（5.8±2.0）（%）,（2.1±1.1）（mg/L）,the differencewas statistically significant（P〈0.05）.The BMI,HbA1 cand hs-CRP abnormal rate of the observation group were34.5%,77% and 60.5%,which was significantly higher than those in the control group（21.0%,18.5%,23.5%）,the difference is statistically significant（P〈0.05）,and the evaluated the specificity and positive predictive value were high of BMI,HbA1 cand hs-CRP in diagnosing gestational diabetes mellitus.Conclusion BMI,HbA1 cand hs-CRP might be used as important clinical markers in the early diagnosis of gestational diabetes mellitus.