孕前体质量指数、孕早期空腹血糖及血脂水平预测妊娠期糖尿病的诊断意义

The Diagnostic Value of Prepregnancy Body Mass Index,Fasting Blood Glucose and Blood Lipid Level in Early Pregnancy in Predicting Gestational Diabetes Mellitus

目的探讨孕前体质量指数(BMI)、孕早期空腹血糖(FBG)及血脂水平在预测妊娠期糖尿病中的诊断意义。方法选择2013年12月至2017年1月在我院进行常规产前检查的孕妇1207例的资料进行回顾性分析,按照孕妇是否为妊娠期糖尿病分为对照组和病例组,其中对照组未罹患妊娠期糖尿病共1036例,病例组罹患妊娠期糖尿病共171例,对两组患者的数据进行分析,探讨孕前体质量指数、孕早期空腹血糖及血脂水平在预测妊娠期糖尿病中的诊断意义。结果患者的年龄偏大,BMI偏高,孕次较多,空腹血糖值高,甘油三酯(TG)高为孕妇出现妊娠期糖尿病独立危险因素(OR=1.237,1.251,6.652,1.107,1.124,P<0.05),利用年龄,怀孕前BMI,孕次,孕早期FBG,TG对患者进行诊断,最佳截断值分别为29.53岁,24.82 kg/m2,2.06次,5.00 mmol/L,1.48 mmol/L,约登指数分别为31.96%,39.78%,16.07%,46.79%,25.91%。结论妊娠期糖尿病的独立危险因素较多,可以对各项因素进行具有针对性的干预,降低发病率。仅使用独立的指标进行妊娠期糖尿病的预测与诊断,效果欠佳,建议进行多指标的综合考虑。

Objective To explore the diagnostic significance of preconceptual body mass index(BMI),fasting blood glucose(FBG)and blood lipid level in predicting gestational diabetes mellitus.Methods The data of1207pregnant women who underwent routine prenatal care in our hospital from December2013to January2017were retrospectively analyzed.According to whether pregnant women were divided into control group and case group for gestational diabetes,1036cases of gestational diabetes were not found in the control group,and171cases of gestational diabetes were found in the case group.The data of two groups of patients were analyzed to explore the diagnostic significance of pre pregnancy body mass index,fasting blood glucose and blood lipid level in early pregnancy in predicting gestational diabetes mellitus.Results The patients were of higher age,higher BMI,more gestational times,high fasting blood glucose and high triglyceride(TG)as a risk factor for pregnant women(OR=1.237,1.251,6.652,1.107,1.124,P<0.05).The patients were diagnosed with age,BMI,pregnancy,FBG,and TG before pregnancy.The best truncation values were29.53years,24.82kg/m^2,2.06times,5mmol/l,1.48mmol/l,and the Jorden index was31.96%,39.78%,16.07%,46.79%,25.91%.Conclusion There are many independent risk factors for gestational diabetes mellitus,and targeted interventions can be carried out to reduce the incidence of various factors.The use of independent indicators to predict and diagnose gestational diabetes mellitus is not satisfactory.It is suggested that multiple indicators should be considered comprehensively.