妊娠早期体质量指数、三酰甘油水平变化对妊娠糖尿病的预测价值

Predictive value of body mass index and triglyceride level changes in early pregnancy on gestational diabetes mellitus

目的探讨妊娠早期体质量指数(BMI)、三酰甘油(TG)水平对妊娠糖尿病(GDM)的预测价值。方法回顾性分析250例GDM患者(GDM组)和250例正常妊娠妇女(对照组)的产前检查资料,收集妊娠12周时的BMI及TG结果,以妊娠24周时的口服葡萄糖耐量试验(OGTT)结果作为GDM的诊断标准,计算BMI、TG预测GDM的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和准确性。采用受试者工作特征(ROC)曲线分析妊娠早期BMI、TG对GDM的预测价值。采用Pearson相关分析及Logistic回归分析评估BMI、TG与GDM的关系。结果GDM组BMI及血清TG水平明显高于对照组(P=0.000)。Pearson相关分析结果显示,妊娠早期BMI、TG与GDM的发生呈明显正相关(r值分别为0.625、0.641,P<0.01)。ROC曲线分析结果显示,BMI、TG及二者联合检测预测GDM的曲线下面积分别为0.712、0.651、0.889。BMI、TG联合检测预测GDM的敏感性、特异性、PPV、NPV和准确性均高于单项检测。Logistic回归分析结果显示,随着BMI及血清TG水平的升高,GDM发生率逐渐增高(r^2值分别为0.995 5、0.957 3,P<0.05)。结论妊娠早期BMI、TG对GDM的发生具有一定的预测价值。

Objective To study the predictive value of body mass index(BMI),triglyceride(TG)level changes in early pregnancy on gestational diabetes mellitus(GDM).Methods The antenatal examination data of 250 cases of pregnant women diagnosed GDM(GDM group)and 250 cases of non-GDM pregnant women(control group)were analyzed retrospectively.The results of TG and BMI in the gestation of 12 weeks were collected.Oral glucose tolerance test(OGTT)results in the gestation of 24 weeks were as diagnostic gold standard of GDM,the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accuracy of BMI and TG levels in predicting GDM were calculated.The predictive values of BMI and TG during early pregnancy on GDM were analyzed by receiver operating characteristic(ROC)curve.The relationship between BMI,TG and GDM were evaluated by Pearson correlation analysis and Logistic regression analysis.Results BMI and TG levels of GDM group were higher than those of control group(P=0.000).Pearson correlation analysis showed that the incidence of GDM was positively correlated with BMI and TG in early pregnancy(r=0.625 and 0.641,P<0.01).ROC curve showed that the areas under curves of BMI,TG,BMI combined with TG were 0.712,0.651 and 0.889,respectively.The sensitivity,specificity,PPV,NPV and accuracy in predicting GDM of BMI combined with TG in early pregnancy were higher than those of BMI and TG.Logistic regression analysis showed that with the increasing of BMI and TG,the incidence rate of GDM showed a trend of increasing(r^2=0.995 5 and 0.957 3,P<0.05).Conclusions BMI and TG levels in early pregnancy have predictive values for GDM.