孕早期空腹血糖、三酰甘油、血清铁蛋白对妊娠期糖尿病预测价值

Predictive value of fasting blood glucose,triglyceride and serum ferritin in early pregnancy for gestational diabetes mellitus

目的:探讨孕早期空腹血糖(FPG)、三酰甘油(TG)、血清铁蛋白(SF)对妊娠期糖尿病(GDM)的预测价值。方法:选取产科定期常规孕期检查的单胎孕妇560例,于妊娠8~12周测定FPG、TG、SF,于妊娠24~28周行75 g口服葡萄糖耐量试验(OGTT),根据OGTT结果将孕妇分为GDM组109例和糖耐量正常对照组451例。比较两组一般临床资料,采用多因素Logistic回归分析GDM发生独立危险因素,采用受试者工作特征曲线(ROC)评估孕早期FPG、TG、SF对GDM的预测价值。结果:GDM组孕早期FPG、TG、SF水平高于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、孕早期BMI、FPG、TG、SF是GDM发生的独立危险因素(P<0.05)。孕早期FPG、TG及SF三者联合检测预测GDM的曲线下面积(AUC)为0.864,敏感度和特异度分别为89.5%、78.5%。结论:孕早期较高的FPG、TG、SF和GDM的发生具有一定相关性,三者联合检测对GDM具有较高的预测价值。

Objective To explore the predictive value of fasting blood glucose(FPG),triglyceride(TG)and serum ferritin(SF)in early pregnancy for gestational diabetes mellitus(GDM).Method 560 singleton pregnant women with regular routine pregnancy examination in the obstetrics department were selected.FPG,TG and SF were measured at 8~12 weeks of gestation.Oral glucose tolerance test(OGTT)was performed at 24~28 weeks of gestation.According to OGTT results,pregnant women were divided into GDM group(109 cases)and normal glucose tolerance group(451 cases).The general clinical data of the two groups were compared;Multivariate logistic regression analysis was used to determine the independent risk factors of GDM.Receiver operating characteristic curve(ROC)was used to further analyze the predictive value of FPG,TG and SF for GDM.Results The levels of FPG,TG and SF in early pregnancy in GDM group were higher than those in control group(P<0.05).Multivariate logistic regression analysis showed that age,BMI,FPG,TG and SF in early pregnancy were independent risk factors for GDM(P<0.05).The total area under ROC curve predicted GDM by FPG,TG and SF was 0.864,the sensitivity and specificity were 89.5%and 78.5%,respectively.Conclusion The higher levels of FPG,TG,SF in the early pregnancy is related to the occurrence of GDM.The combined detection of FPG,TG and SF in early pregnancy has a certain predictive value for GDM.