孕早期血浆FPG、Hcy及Hb A1c对妊娠期糖尿病的预测价值

The predictive value of plasma FPG,Hcy and HbA1c in gestational diabetes mellitus during early pregnancy

目的:探究孕早期血浆空腹血糖(FPG)、同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)对妊娠期糖尿病发生的预测价值。方法:回顾性收集医院确诊为妊娠期糖尿病的120例孕妇作为研究组,另取同期于该院产检正常的120例孕妇为对照组,对比两组孕妇FPG、Hcy及HbA1c水平差异,随访两组孕妇不良妊娠结局差异,采用绘制受试者特征曲线(ROC)计算血浆FPG、Hcy及HbA1c对妊娠期糖尿病的诊断效能。结果:研究组孕妇的血浆FPG、Hcy及HbA1c水平均明显高于对照组孕妇(P<0.05);研究组孕妇的不良妊娠结局发生率均明显高于对照组(P<0.05);血浆FPG、Hcy及HbA1c水平对妊娠糖尿病的诊断曲线下面积(AUC)分别为0.6835(P<0.0001)、0.5892(P=0.0409)、0.6501(P=0.0006),而联合检测的AUC为0.9502(P<0.0001),组间比较联合检测的灵敏度和特异度均优于任一种检测指标(P<0.05)。结论:孕早期妊娠糖尿病患者血浆FPG、Hcy及HbA1c水平与健康孕妇存在较大的差异,上述指标在预测妊娠糖尿病及不良妊娠结局方面中具有一定的应用效能,建议临床推广运用。

Objective:To explore the predictive value of plasma fasting blood glucose(FPG),homocysteine(Hcy)and glycosylated hemoglobin(HbAic)in the early pregnancy on the incidence of diabetes in pregnancy:Methods:A total of 120 pregnant women diagnosed with gestational diabetes in hospital were retrospectively collected as the study group while 120 pregnant women with normal obstetrical examinations in our hospital during the same period were selected as the control group.The differences of FPG,Hcy and HbAlc levels between the two groups were compared,and the differences of adverse pregnancy outcomes between the two groups were followed up.The diagnostic efficacy of plasma FPG,Hcy and HbAlc in gestational diabetes mellitus was calculated by receiver characteristic curve(ROC).Results:The plasma levels of FPG,Hcy and HbAlc in the study group were significantly higher than those in the control group(P<0.05).The incidence of adverse pregnancy outcome in the study group was significantly higher than that in the control group(P<0.05).The area under the diagnostic curve(AUC)of plasma FPG,Hcy and HbA1c levels for gestational diabetes mellitus were 0.6835(P<0.0001),0.5892(P=0.0409)and 0.6501(P=0.0006),respectively,while the AUC of combined detection was 0.9502(P<0.0001).The sensitivity and specificity of combined detection were better than any other detection index(P<0.05).Conclusion:The plasma FPG,Hcy and HbAlc levels of gestational diabetes mellitus patients in early pregnancy differ significantly from those of healthy pregnant women,and the above-mentioned indicators have certain application efficacy in predicting gestational diabetes mellitus and adverse pregnancy outcomes,and are recommended for clinical application.