空腹血糖联合年龄在妊娠糖尿病筛查中的应用价值

The value of fasting plasma glucose combined with maternal age in the screening of gestational diabetes mellitus

目的评估空腹血糖(FPG)联合年龄在妊娠糖尿病(GDM)筛查中的应用价值。方法对2021年1-3月在该院行口服葡萄糖耐量试验(OGTT)的1597例妊娠24~28周孕妇进行回顾性分析,根据OGTT结果分为对照组和GDM组,其中GDM组进一步根据FPG的水平分为GDM-FPG正常组和GDM-FPG异常组,分析FPG和年龄在GDM筛查中的价值。结果1597例孕妇中,对照组1346例,GDM组251例,GDM患病率为15.72%;其中GDM-FPG正常组166例(66.14%),GDM-FPG异常组85例(33.86%);GDM-FPG正常组的年龄和FPG水平均高于对照组,差异有统计学意义(P<0.05);通过对FPG水平正常的孕妇按年龄段及FPG水平四分位数区间分组分值分析发现,年龄>35岁且FPG为>4.59~<5.10 mmol/L的孕妇GDM患病率最高(28.85%)。FPG为>4.59~<5.10 mmol/L无论年龄、年龄>35岁无论FPG水平以及FPG为>4.36~4.59 mmol/L且年龄>30岁的孕妇,GDM患病率均在10%以上。结论FPG联合年龄在GDM的诊断中有一定的应用价值,对于FPG水平和年龄在特定区间的孕妇,即使FPG<5.10 mmol/L,也应尽可能完成OGTT。

Objective To investigate the value of fasting plasma glucose(FPG)combined with maternal age in the screening of gestational diabetes mellitus(GDM).Methods Data of 1597 pregnant women from 24 to 28 weeks of gestation who underwent oral glucose tolerance test(OGTT)were obtained from the hospital from January to March 2021.The pregnant women were divided into two groups according to the results of OGTT.The GDM pregnant women were further divided into the GDM-FPG normal group and the GDM-FPG abnormal group according to the level of FPG.The value of FPG and maternal age in GDM screening were analyzed statistically.Results Among 1597 pregnant women,1346 were in the control group and 251 were in the GDM group.The prevalence of GDM was 15.72%.Among 251 women were diagnosed GDM,there were 85(33.86%)cases in GDM-FPG abnormal group,while 166(66.14%)cases in GDM-FPG normal group.Compared to the control group,the level of FPG and maternal age were increased significantly in GDM-FPG normal group(P<0.05).Throngh the group analysis of pregnant women with normal FPG by age and FPG quartile interval,we found that the highest incidence of GDM(28.85%)was pregnant women with maternal age>35 years and FPG at>4.59-<5.10 mmol/L.In addition,the incidence of GDM was more than 10%in pregnant women with FPG at>4.59-<5.10 mmol/L regardless of age,maternal age>35 years regardless of the level of FPG,and those with FPG at>4.36-4.59 mmol/L and maternal age>30 years.Conclusion FPG combined with maternal age play a certain role in the diagnosis of GDM.It suggests that even if the level of FPG is less than 5.10 mmol/L,OGTT should be performed in pregnant women with certain FPG and maternal age.