妊娠8~15周孕妇平均血小板体积预测早期妊娠期糖尿病价值

Value of mean platelet volume during 8-15 gestational weeks for predicting early gestational diabetes mellitus

目的:探讨孕815周孕妇平均血小板体积(MPV)对早期妊娠期糖尿病(GDM)的预测价值。方法:回顾性收集临床资料,孕2428周经糖耐量测试诊断为GDM的孕妇168例为GDM组,糖耐量正常孕妇200例为对照组。对比其包括MPV在内的临床资料差异,采用logistics回归分析GDM发生的危险因素,采用受试者工作特征(ROC)曲线分析孕815周MPV对GDM发生的预测价值。结果:两组孕妇年龄、糖尿病家族史、孕前体质指数及孕815周空腹血糖、MPV、胆固醇水平有差异(P<0.05),受教育程度、生育史及孕815周白细胞、红细胞、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、甘油三酯水平无差异(P>0.05)。logistics回归分析发现,年龄≥35岁、合并糖尿病家族史、孕前体质指数≥24kg/m^(2),孕815周空腹血糖、MPV、甘油三酯水平较高均是GDM发生的独立危险因素(P<0.05)。ROC曲线分析,孕815周MPV预测GDM的最佳截断值为10.33fl,AUC为0.773(95%CI 0.7270.819),对应的灵敏度、特异度分别为65.0%、72.6%。结论:孕815周MPV水平较高是早期GDM发生的独立危险因素,且对孕中期GDM确诊有一定预测价值。

Objective: To investigate the value of mean platelet volume(MPV) of pregnant women during 8-15 gestational weeks for predicting their early gestational diabetes mellitus(GDM) occurrence. Methods: The clinical data of pregnant women were collected retrospectively, which included 168 cases with GDM diagnosed by glucose tolerance test during 24-28 gestational weeks in group A and 200 cases with normal glucose tolerance in group B. The difference of clinical data of the women, such as MPV value, was compared between the two groups. The risk factors of GDM were analyzed by logistics regression. The predictive value for GDM of MPV value of the women during 8-15 gestational weeks was analyzed by receiver operating characteristic(ROC) curve. Results: There were significant differences in maternal age, family history of diabetes mellitus, the pre-pregnancy BMI value, and the FPG, MPV and TC levels during 8-15 gestational weeks of the women between the two groups(P<0.05). There were no significant differences in education level, reproductive history, and the levels of WBC, RBC, ALT, AST and TG during 8-15 gestational weeks of the women between the two groups(P>0.05). Logistics regression analysis found that age ≥35 years old, family history of diabetes, pre-pregnancy BMI≥24 kg/m^(2), high levels of FPG, MPV and TC during 8-15 gestational weeks were all the independent risk factors of GDM(P<0.05). ROC curve analysis showed that the optimal cut-off value of MPV value for predicting GDM of the women during 8-15 gestational weeks was 10.33 fl, and the AUC was 0.773(95%CI 0.727-0.819), and the sensitivity and the specificity were 65.0% and 72.6%, respectively. Conclusion: High MPV value of the pregnant women during 8-15 gestational weeks is an independent risk factor of GDM, which also has some predictive value for GDM during the second trimester of pregnancy.