妊娠期糖尿病孕妇血WBC、FBG、Cr、ALT变化及早期筛查和风险评估价值

Changes of the white blood cell count,and the levels of fasting blood glucose,serum creatinine,and alanine aminotransferase of pregnant women with gestational diabetes mellitus and their early screening and risk evaluation of gestational diabetes mellitus

目的:探讨妊娠期糖尿病(GDM)患者白细胞计数(WBC)、空腹血糖(FBG)、血肌酐(Cr)与丙氨酸氨基转移酶(ALT)水平及早期筛查和风险评估价值。方法:回顾性分析2020年5月—2021年12月在本院产前检查的孕妇542例临床资料,分为GDM组(n=60)与对照组(n=482),对比两组WBC、FBG、Cr、ALT差异,采用Spearman相关系数分析以上指标与GDM发病关系;绘制受试者工作特征(ROC)曲线分析WBC、FBG、Cr、ALT早期筛查GDM效能;多因素回归分析GDM发病相关风险因子。结果:GDM组Cr、WBC、FBG、ALT表达均高于对照组,且均与GDM发病正相关(均P<0.05);ROC分析,WBC、FBG、Cr、ALT联合检测的曲线下面积最高(0.851),敏感度90.1%、特异度为87.6%;WBC≥6.41×10~9/L、FBG≥5.16mmol/L、ALT≥14.98U/L、体质指数≥22.32kg/m~2、Cr≥50.62μmol/L、吸烟是GDM发生的风险因子,而孕妇本科及以上学历为保护因素。结论:GDM妇女血WBC、FBG、ALT、Cr异常高表达,联合检测对早期筛查GDM有一定效能,控制BMI、降低吸烟频率并提高孕产妇知识储备对降低GDM发生有一定作用。

Objective:To investigate the white blood cell count(WBC),and the levels of fasting blood glucose(FBG),serum creatinine(Cr),and alanine aminotransferase(ALT)of pregnant women with gestational diabetes mellitus(GDM),and to study their values for the early screening and risk evaluation of GDM.Methods:The clinical data of 542pregnant women who had undergone antenatal examination from May 2020to December 2021were analyzed retrospectively.These women were divided into study group(60women with GDM)and control group(482women without GDM).The differences of the WBC,and the levels of FBG,Cr,and ALT of the women were compared between the two groups.Spearman correlation coefficient was used to analyze the correlation between the WBC,and the levels of FBG,Cr,and ALT of the women and their GDM occurrence.Receiver operator characteristic(ROC)curve was drawn to analyze the efficacy of the WBC,and the levels of FBG,Cr,and ALT of the women for early screening their GDM.Multivariate regression analysis was used to analyze the related risk factors of GDM occurrence.Results:The WBC,and the levels of the Cr,FBG,and ALT of the women in the study group were significantly higher than those of the women in the control group,and which of the women were all positively correlated with their GDM occurrence(all P<0.05).ROC analysis showed that the area under the curve of the combined detections of WBC,and the levels of FBG,Cr,and ALT of the women for predicting their GDM occurrence was 0.851,and which was the highest,with the sensitivity of 90.1%and the specificity of 87.6%.The WBC≥6.41×10^(9)/L,the FBG level≥5.16mmol/L,ALT≥14.98U/L,the value of body mass index≥22.32kg/m^(2),the Cr level≥50.62μmol/L,and smoking of the women were the risk factors of their GDM occurrence,while the bachelor's degree or above of the educational level of the women was the protective factor of their GDM occurrence.Conclusion:The WBC,and the levels of Cr,FBG,and ALT of the women with GDM increase,and the combined detections of the WBC,and the levels of Cr,FBG,and ALT of the women has certain predictive efficacy for their early screening GDM.The maternal controlled BMI,the reduced smoking frequency,and the increased knowledge reserve may play a certain role in reducing the GDM occurrence of the pregnant women.