IADPSG标准下75g和100g OGTT诊断GDM的价值比较

Comparison of diagnostic value of 75g and 100 g OGTT for GDM under IADPSG standard

目的比较IADPSG标准下75g和100g OGTT诊断GDM的价值。方法选取2017年8月1日至2019年8月1日在铜川市人民医院进行GDM筛查的1069例孕妇作为研究对象,其中573例进行75g OGTT(75g组),496例进行100g OGTT(100g组)。比较两组诊断GDM的临床价值。结果两组孕妇的空腹葡萄糖水平无显著差异(P>0.05)。75g组服糖1、2 h的葡萄糖水平低于100g组(P<0.05)。75g组采用IADPSG诊断阈值而100g组采用ADA诊断阈值时,75g组GDM诊断率高于100g组(P<0.05);两组均采用IADPSG诊断阈值时,GDM诊断率无显著差异(P>0.05)。采用IADPSG诊断标准时,两组的空腹、服糖后1 h阳性率无显著差异(P>0.05);75g组服糖后2 h阳性率低于100g组(P<0.05)。两组均采用IADPSG诊断阈值时,通过1个点阳性和2个点阳性诊断为GDM的占比无显著差异(P>0.05);75 g组通过3个点阳性诊断为GDM的占比低于100 g组,差异具有统计学意义(P<0.05)。结论采用IADPSG的诊断阈值时,75g OGTT与100g OGTT的GDM诊断率无统计学差异,但二者通过3个点阳性诊断GDM的占比稍有不同。

Objective To compare the diagnostic value of 75 g and 100 g OGTT for GDM under IADPSG standard.Methods A total of 1069 pregnant women who underwent GDM screening in people's hospital of Tongchuan from August 1,2017 to August 1,2019 were selected as the research objects.Among them,573 cases received 75 g OGTT(75 g group)and 496 cases received 100 g OGTT(100 g group).The clinical value of the two groups in diagnosis of GDM were compared.Results There was no significant difference in fasting glucose level between the two groups(P>0.05).The glucose levels of the 75 g group after taking sugar for 1 and 2 h were lower than those of the 100 g group(P<0.05).When IADPSG diagnostic criteria threshold was used in the 75 g group and ADA diagnostic threshold was used in the 100 g group,the GDM diagnostic rate of the 75 g group was higher than that of the 100 g group(P<0.05);there was no significant difference in the GDM diagnostic rate between the two groups when IADPSG was used as the diagnostic threshold(P>0.05).When IADPSG diagnosis criteria was used,there were no significant differences in the positive rate of fasting and after taking sugar for 1 h between the two groups(P>0.05);the positive rate in the 75 g group after taking sugar for 2 h was lower than that in the 100 g group(P<0.05).When IADPSG diagnostic threshold was used in both groups,there were no significant differences in the proportions of GDM diagnosed by 1 spot positive and 2 spot positive(P>0.05);the proportion of GDM diagnosed by 3 spot positive of the 75 g group was lower than that of the 100 g group,and the difference was statistically significant(P<0.05).Conclusion When the diagnostic threshold of IADPSG was used,there was no difference in the diagnostic rate of GDM between 75 g OGTT and 100 g OGTT,but the proportion of GDM diagnosed by 3 spot positive of the two was slightly different.