孕早期空腹血糖、糖化血红蛋白及白细胞联合检测对妊娠期糖尿病的预测价值

Predictive value of fasting plasma glucose,glycated hemoglobin and white blood cell combined detection in early pregnancy for gestational diabetes mellitus

目的探讨孕早期空腹血糖、糖化血红蛋白及白细胞联合检测对妊娠期糖尿病的预测价值。方法选取2018年1月-2020年12月于北京市石景山医院产检确诊的妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇78例纳入GDM组,同期糖耐量正常(非GDM)孕妇85例纳入非GDM组,详细记录受试者孕早期空腹血糖、糖化血红蛋白及白细胞水平,分析孕早期空腹血糖、糖化血红蛋白及白细胞对妊娠期糖尿病发生的预测价值。结果GDM组孕早期空腹血糖、糖化血红蛋白及白细胞水平高于非GDM组(P<0.01)。二元Logistic回归分析显示孕早期空腹血糖、糖化血红蛋白及白细胞是妊娠期糖尿病独立影响因素(OR=1.741、6.682、1.095,P<0.05)。孕早期空腹血糖、糖化血红蛋白及白细胞独立预测妊娠期糖尿病时曲线下面积(AUC)分别为0.646、0.678、0.614,而三者联合诊断时AUC为0.735。结论孕早期血清空腹血糖、糖化血红蛋白及白细胞是妊娠期糖尿病的独立影响因素,将三者联合检测可提高妊娠期糖尿病的预测价值。

Objective To investigate the predictive value of fasting plasma glucose(FPG),glycated hemoglobin(HbA1c)and white blood cell(WBC)combined detection in early pregnancy on gestational diabetes mellitus.Methods A total of 78 pregnant women diagnosed with gestational diabetes mellitus(GDM)at Beijing Shijingshan Hospital from January 2018 to December 2020 were included in the GDM group.Additionally,85 pregnant women with normal glucose tolerance(non-GDM)during the same period were selected as the nonGDM group.The data of FPG,HbA1c and WBC in the first trimester of pregnancy was measured and recorded.FPG,HbA1c and WBC were analyzed to the predictive value in the development of gestational diabetes mellitus.Results The GDM group had higher FPG,HbA1c and WBC in the first trimester than those in the non-GDM group(P<0.01).Binary logistic regression analysis showed that FPG,HbA1c and WBC were influencing factors of gestational diabetes mellitus in the first trimester(OR=1.741,6.682,1.095,P<0.05).The area under the curve(AUC)in the independent prediction of gestational diabetes mellitus in the early trimester FPG,HbA1c and WBC was 0.646,0.678 and 0.614,respectively,while the AUC was 0.735 when the three were diagnosed.Conclusions Serum FPG,HbA1c and WBC in early pregnancy are the influencing factors of gestational diabetes,and the combined detection of the three could improve the predictive value of gestational diabetes mellitus.