妊娠早期进行糖脂代谢指标监测对妊娠期糖尿病的临床预测价值

Clinical predictive value of glucose and lipid metabolism monitoring in early pregnancy for gestational diabetes

目的 探索妊娠期糖尿病发生的危险因素,分析孕早期血糖血脂及联合检查对妊娠期糖尿病发生的预测价值。方法 将2021年1月-2022年1月期间接受产检的孕妇275例作为研究对象,孕早期(妊娠11~13周)进行了空腹血糖(FPG)和三酰甘油(TG)等相关指标的检查及资料收集,孕24~28周产检时进行口服葡萄糖耐量试验(OGTT),根据测试结果诊断妊娠期糖尿病。其中妊娠期糖尿病孕妇51例作为观察组,其余224例作为对照组。采用多因素Logistic回归分析分析妊娠期糖尿病的危险因素,绘制受试者工作特征(ROC)曲线分析孕早期TG、FPG及联合检查对妊娠期糖尿病预测价值。结果 单因素分析发现两组年龄、孕次、初次分娩、有糖尿病家族史、孕早期BMI、孕早期FPG、孕早期TG、孕期体重增加量、孕早期收缩压、孕早期舒张压、孕早期血红蛋白差异均有统计学意义(P<0.05)。Logistic回归分析结果发现年龄≥35岁、孕早期BMI、孕早期FPG、孕早期TG为妊娠期糖尿病发生的独立危险因素。ROC曲线结果孕早期FPG、TG及联合检测曲线下面积分别为0.695、0.680及0.710。结论 年龄≥35岁、孕早期BMI、孕早期FPG、孕早期TG为妊娠期糖尿病发生的独立危险因素;孕早期FPG、TG及联合检测对妊娠期糖尿病均有一定的预测价值,联合检测效果更好。

Objective To explore the risk factors of diabetes in pregnancy,and to analyze the predictive value of blood glucose and lipids in early pregnancy and combined examination on the occurrence of diabetes in pregnancy.Methods Two hundred and seventy-five pregnant women who received antenatal examination from January 2021 to January 2022 were selected as the study subjects.Fasting blood glucose(FPG),triglyceride(TG)and other related indicators were examined and data were collected in the first trimester(11-13 weeks of pregnancy).Oral glucose tolerance test(OGTT)was performed during antenatal examination from 24-28 weeks of pregnancy,and pregnancy diabetes was diagnosed according to the test results.Among them,51 pregnant women with gestational diabetes were treated as the observation group,and 224 as the control group.Multivariate logistic regression analysis was used to analyze the risk factors of gestational diabetes,and the ROC curve of subjects was drawn to analyze the predictive value of early pregnancy TG,FPG and combined examination on gestational diabetes.Results Univariate analysis showed that there were significant differences between the two groups in age,pregnancy times,first delivery,family history of diabetes,BMI,FPG,TG,weight gain,systolic blood pressure,diastolic blood pressure and hemoglobin in early pregnancy(P<0.05).Logistic regression analysis showed that age≥35 years,BMI in the first trimester,FPG in the first trimester,and TG in the first trimester were independent risk factors for diabetes in pregnancy.ROC curve showed that the area under FPG,TG and combined detection curve in early pregnancy were 0.695,0.680 and 0.710 respectively.Conclusion Age≥35 years,BMI,FPG and TG in the first trimester are independent risk factors for diabetes in pregnancy;FPG,TG and combined detection in early pregnancy have certain predictive value for gestational diabetes,and the combined detection effect is better.