孕早期血糖、血脂及体质量水平预测妊娠糖尿病发生风险

Early Pregnancy Blood Glucose,Blood Lipids and Weight Levels Predict the Risk of Gestational Diabetes

目的:探讨孕早期血糖、血脂及体质量水平预测妊娠糖尿病发生风险的临床价值。方法:回顾性分析2018年1月至2019年12月赣南医学院第一附属医院产科门诊产检孕妇80例为研究对象。按照入组时是否诊断为妊娠糖尿病分为两组(观察组诊断为妊娠糖尿病,对照组排除妊娠糖尿病),各40例。统计两组空腹血浆葡萄糖、血脂(包括低密度脂蛋白、甘油三酯、总胆固醇等)、体质量指数的差异。用Spearman相关性分析孕14周前空腹血糖水平与孕中期口服葡萄糖耐量试验(OGTT)0 h、1 h、2 h血糖水平的相关性,并绘制孕14周前空腹血糖预测妊娠糖尿病的ROC曲线并计算AUC面积。联合以上指标对妊娠糖尿病发病风险进行预测。结果:观察组空腹血糖、低密度脂蛋白、甘油三酯和总胆固醇、体质量指数均显著大于对照组(P<0.05),孕14周前空腹血糖水平与孕中期OGTT 0 h、1 h、2 h血糖水平变化均呈正相关,孕14周前空腹血糖预测妊娠糖尿病的ROC曲线AUC面积为0.8420。结论:结合孕14周前空腹血糖、血脂指标及体质量指数评估能有效预测妊娠糖尿病发生风险。

Objective:To explore the clinical value of blood glucose,blood lipids and body weight levels in early pregnancy in predicting the risk of gestational diabetes.Methods:A retrospective analysis of 80 pregnant women undergoing obstetrics in the Obstetrics Clinic of the First Affiliated Hospital of Gannan Medical College from January 2018 to December 2019 was the research object.According to whether they were diagnosed with gestational diabetes at the time of entry,they were divided into two groups(the observation group was diagnosed with gestational diabetes,and the control group excluded gestational diabetes),each with 40 cases.The differences in fasting plasma glucose,blood lipids(including low-density lipoprotein,triglycerides,total cholesterol,etc.),and body mass index between the two groups were counted.Spearman correlation analysis was used to analyze the correlation between fasting blood glucose levels before 14 weeks of gestation and OGTT 0 h,1 h,2 h blood glucose levels in the second trimester,and draw the ROC curve of fasting blood glucose before 14 weeks of gestation to predict gestational diabetes and calculate the AUC area.Combine the above indicators to predict the risk of gestational diabetes.Results:The fasting blood glucose,low-density lipoprotein,triglycerides,total cholesterol,and body mass index of the observation group were significantly higher than those of the control group(P<0.05).The fasting blood glucose levels before 14 weeks of pregnancy and the OGTT 0 h,1 h,and 2 h blood glucose levels in the second trimester were changed both are positively correlated.The AUC area of the ROC curve for predicting gestational diabetes by fasting blood glucose before 14 weeks'gestation is 0.8420.Conclusion:The combination of fasting blood glucose,blood lipids and body mass index assessment before 14 weeks of gestation can effectively predict the risk of gestational diabetes.