Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

Effect of resveratrol in gestational diabetes mellitus and its complications

The incidence rate of diabetes in pregnancy is about 20%,and diabetes in pregnancy will have a long-term impact on the metabolic health of mothers and their offspring.Mothers may have elevated blood glucose,which may lead to blood pressure disease,kidney disease,decreased resistance and secondary infection during pregnancy.The offspring may suffer from abnormal embryonic development,intrauterine growth restriction,obesity,autism,and other adverse consequences.Resveratrol(RSV)is a natural polyphenol compound,which is found in more than 70 plant species and their products,such as Polygonum cuspidatum,seeds of grapes,peanuts,blueberries,bilberries,and cranberries.Previous studies have shown that RSV has a potential beneficial effect on complex pregnancy,including improving the indicators of diabetes and pregnancy diabetes syndrome.This article has reviewed the molecular targets and signaling pathways of RSV,including AMP-activated protein kinase,mitogen-activated protein kinases,silent information regulator sirtuin 1,miR-23a-3p,reactive oxygen species,potassium channels and CX3C chemokine ligand 1,and the effect of RSV on gestational diabetes mellitus(GDM)and its complications.RSV improves the indicators of GDM by improving glucose metabolism and insulin tolerance,regulating blood lipids and plasma adipokines,and modulating embryonic oxidative stress and apoptosis.Furthermore,RSV can ameliorate the GDM complications by reducing oxidative stress,reducing the effects on placentation,reducing the adverse effects on embryonic development,reducing offspring's healthy risk,and so on.Thus,this review is of great significance for providing more options and possibilities for further research on medication of gestational diabetes.

Early neonatal complications in pregnant women with gestational diabetes mellitus and the effects of glycemic control on neonatal infection

BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal infection.METHODS The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were compared.The patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to standards.Baseline data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two groups.RESULTS The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P<0.05).Pregnant women with GDM in the NCGC group(n=178)had significantly higher fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group(n=58)(P<0.05).There were no differences in baseline data between the two groups(P>0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(P<0.05),while white blood cells,serum procalcitonin and C-reactive protein levels increased significantly.The neonatal infection rate was also significantly increased in the NCGC group(P<0.05).CONCLUSION The risk of neonatal complications increased in pregnant women with GDM.Poor glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.

Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus

Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c(Hb A1c); however, we have demonstrated that Hb A1 c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, largepopulation epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.

Gestational Diabetes Mellitus: New Diagnostic Criteria

Gestational mellitus diabetes (GDM) is a highly prevalent metabolic disorder among pregnant women nowadays. It is defined as any level of glucose intolerance, appearing or first being recognized during pregnancy. It is essential to diagnose and treat GDM early, in order to reduce or avoid complications for mother and fetus. Recently, new guidelines have changed the diagnosis criteria, and it is expected that the prevalence of GDM will increase by approximately 18%. A relevant goal of these new definitions is to provide a better care for pregnant women, in an attempt to reduce fetal and maternal complications. These new criteria will also increase the impact on costs of the health care system. Treatment must be individualized for best results, including a specific diet, physical activity and the use of medications. Metformin and Insulin use are analyzed in detail, in face of new evidences regarding their safety and efficacy during pregnancy.

Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough?

Periodontitis is the commonest oral disease affecting population worldwide.This disease is notorious for the devastation of tooth supporting structures,ensuing in the loss of dentition.The etiology for this disease is bacterial biofilm,which accumulates on the teeth as dental plaque.In addition to the biofilm microorganisms,other factors such as environmental,systemic and genetic are also responsible in progression of periodontitis.Diabetes mellitus(DM) is metabolic disorder which has an impact on the global health.DM plays a crucial role in the pathogenesis of periodontitis.Periodontitis is declared as the "sixth" major complication of DM.Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM.A "two way" relationship has been purported between periodontitis and DM.Mutual management of both conditions is necessary.Periodontal therapy(PT) may assist to diminish the progression of DM and improve glycemic control.Various advanced technological facilities may be utilized for the purpose of patient education and disease management.The present paper clarifies the etio-pathogenesis of periodontitis,establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis.The role of PT in amelioration of DM and application of digital communication will be discussed.Overall,it is judicious to create an increased patient cognizance of the periodontitis-DM relationship.Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.

Pregnancy complications effect on the nickel content in maternal blood,placenta blood and umbilical cord blood during pregnancy

BACKGROUND Nickel(Ni)may accumulate in the human body and has biological toxicity and carcinogenicity.Ni has an extensive impact on the health of pregnant women and fetuses during gestation.AIM To evaluate Ni exposure in pregnant women in Kunming,Yunnan Province,China;to describe the distribution of Ni in the maternal-fetal system and placental barrier function;and to investigate the effect of Ni exposure on fetal health in mothers with pregnancy complications.METHODS Seventy-two pregnant women were selected using a case-control design.The women were divided into two groups:The control group(no disease;n=29)and the disease group[gestational diabetes(GDM),hypertensive disorder complicating pregnancy(HDCP),or both;n=43].The pregnant women in the disease group were further divided as follows:14 cases with GDM(GDM group),13 cases with HDCP(HDCP group)and 16 cases with both GDM and HDCP(disease combination group).Basic information on the pregnant women was collected by questionnaire survey.Maternal blood,placenta blood and cord blood were collected immediately after delivery.The Ni content in paired samples was determined using inductively coupled plasma mass spectrometry.RESULTS Compared to the control group,age was higher and body mass index was greater in pregnant women in the disease groups(28.14±2.54 vs 28.42±13.89,P<0.05;25.90±3.86 vs 31.49±5.30,P<0.05).The birth weights of newborns in the HDCP group and the control group were significantly different(2.52±0.74 vs 3.18±0.41,P<0.05).The content of Ni in umbilical cord blood in the entire disease group was higher than that in the control group(0.10±0.16 vs 0.05±0.07,P<0.05).CONCLUSION In the maternal-fetal system of women with pregnancy complications,the barrier effect of the placenta against Ni is weakened,thus affecting healthy growth of the fetus in the uterus.

妊娠期糖尿病合并妊娠期高血压疾病患者血清miR-518、炎症因子水平及临床意义

目的分析妊娠期糖尿病(GDM)合并妊娠期高血压疾病(HDP)患者血清miR-518水平与炎症因子的相关性。方法选择2021年8月至2022年8月于该院产科门诊建档并定期产检的孕妇140例为研究对象,其中67例GDM合并HDP患者纳入观察组,53例单纯GDM患者纳入对照组,20例正常妊娠女性纳入健康组。观察组中,GDM合并妊娠期高血压29例,GDM合并轻度子痫前期24例,GDM合并重度子痫前期14例。采用酶联免疫吸附试验检测所有研究对象血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-10水平,采用实时荧光定量聚合酶链反应检测所有研究对象血清miR-518水平。结果对照组、观察组miR-518、TNF-α、IL-6、IL-10水平明显高于健康组,且观察组miR-518、TNF-α、IL-6、IL-10水平明显高于对照组,差异均有统计学意义(P<0.05)。与GDM合并妊娠期高血压患者比较,GDM合并轻度子痫前期患者、GDM合并重度子痫前期患者血清miR-518、TNF-α、IL-6、IL-10水平明显升高,差异均有统计学意义(P<0.05)。与GDM合并轻度子痫前期患者比较,GDM合并重度子痫前期患者的血清miR-518、TNF-α、IL-6、IL-10水平明显升高,差异均有统计学意义(P<0.05)。观察组患者血清miR-518水平与血清TNF-α、IL-6、IL-10水平均呈正相关(P<0.05),且疾病越严重,相关系数越大。结论GDM合并HDP患者血清miR-518水平与TNF-α、IL-6、IL-10水平呈正相关,且疾病越严重,相关程度越高,或可通过调控miR-518的表达影响GDM合并HDP患者血清中的炎症因子水平。

快速康复护理对妊娠期糖尿病产妇剖宫产术后并发症发生率及血糖水平的影响

目的 探析快速康复护理在妊娠期糖尿病(GDM)产妇剖宫产围手术期中的实施效果和价值。方法 选取2022年7月至2023年6月本院收治的70例行剖宫产的GDM产妇,采用随机数字表法分为两组,对照组(35例)采用常规护理,观察组(35例)采用快速康复护理,比较两组术中血糖变化、术后并发症发生率、疼痛缓解情况、术后恢复情况。结果 术中观察组血糖水平较对照组更低(P <0.05)。观察组并发症发生率2.86%较对照组17.14%更低(P <0.05)。术后术后12、24、48、72 h观察组疼痛评分(VAS)均较对照组更低(P <0.05)。观察组术后首次肛门排气、离床、排便及住院时间均较对照组更短(P <0.05)。观察组护理满意度较对照组更高(P <0.05)。结论 快速康复护理对GDM产妇剖宫产术中血糖水平控制、术后并发症减少、疼痛缓解及护理满意度提升等均可产生积极影响。

维生素D联合诺和锐特充治疗GDM临床效果

目的:探究维生素D联合诺和锐特充治疗妊娠期糖尿病(GDM)效果。方法:选取2020年1月-2023年1月本院收治的GDM患者114例,随机数表法分为胰岛组(n=57)和联合组(n=57),两组均给予诺和锐特充皮下注射治疗,联合组同时口服维生素D滴剂,均持续治疗至血糖达标,比较两组治疗前、分娩前血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、胰岛素指标[空腹胰岛素(FINS)、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、血脂指标(血浆脂肪酸、总胆固醇、甘油三酯)、同型半胱氨酸(Hcy)、Toll样受体4(TLR4)、血管细胞粘附分子(VCAM-1),随访母婴结局。结果:治疗后分娩前,两组FPG、2hPG、HbA1c均下降(P<0.05)但两组无差异(P>0.05),两组FINS、HOMA-IR均下降,HOMA-β均上升,且联合组指标(12.76±1.46μU/ml、2.98±0.23、89.52±8.10)改善优于胰岛组(12.87±1.52μU/ml、3.30±0.52、81.41±8.08),两组血脂指标均下降且联合组低于胰岛组,两组TLR4、VCAM-1、Hcy均下降且联合组(6.71±1.38 mU/L、43.63±7.47 ng/ml、8.47±1.85μmol/L)低于胰岛组(8.49±1.46 mU/L、52.47±7.63 ng/ml、11.21±2.76μmol/L)(均P<0.05);胰岛组与联合组不良母婴结局发生率(14.0%比8.8%)无差异(P>0.05)。结论:维生素D辅助诺和锐特充治疗GDM,有利于改善患者胰岛素抵抗及脂代谢功能,抑制Hcy等促炎因子表达,未增加不良母婴结局风险。

有氧运动联合营养干预对妊娠糖尿病患者血糖血脂的影响

目的探讨有氧运动联合营养干预对妊娠糖尿病(GDM)患者血糖血脂水平的影响。方法选取2022年1月至2023年1月宜春市妇幼保健院妇产科收治的66例GDM患者作为研究对象,采用随机数字表法将其分为对照组和观察组,各33例。对照组采用常规门诊健康教育,观察组采用有氧运动联合营养干预。比较两组的血糖、血脂水平、围生期并发症及不良妊娠结局。结果观察组干预后的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平低于对照组,差异有统计学意义(P<0.05);观察组干预后的血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)水平低于对照组,高密度脂蛋白(HDL)水平高于对照组,差异有统计学意义(P<0.05);观察组的围生期并发症总发生率低于对照组,差异有统计学意义(P<0.05);观察组的不良妊娠结局总发生率低于对照组,差异有统计学意义(P<0.05)。结论对GDM患者实施有氧运动联合营养干预效果理想,能够降低GDM患者血糖及血脂水平,减少围生期并发症及不良妊娠结局的发生。

精蛋白人胰岛素注射液对GDM患者血糖及妊娠结局的影响

目的:探究门冬胰岛素联合精蛋白人胰岛素注射液治疗妊娠期糖尿病(GDM)对患者血红蛋白(HGB)、C反应蛋白(CRP)、C肽(CP)及血糖和安全性影响。方法:选取2020年12月-2023年12月本院治疗的GDM患者106例,双色球分组法分为常规组和观察组各53例。两组均给予门冬胰岛素降糖治疗,观察组给予精蛋白合成人胰岛素注射治疗,两组均治疗2个月。治疗前后分别检测空腹血糖(FBG)、糖化血红蛋白(HbA1c)和餐后2 h血糖(2hPG)水平,空腹胰岛素(FINS)水平并计算胰岛素抵抗指数(HOMA-IR),HGB、CP、CRP和白介素-6(IL-6)水平;收集两组不良妊娠结局。结果:治疗2个月后两组FBG、HbAlc、2hPG、HOMA-IR、HGB、CRP和IL-6均降低,且观察组(4.06±0.28 mmol/L、4.15%±0.26%、5.05±0.36 mmol/L、2.29±0.47、134.79±5.32 g/L、5.01±0.12 mg/L、6.33±0.70 ng/ml)均低于常规组(5.11±0.48 mmol/L、5.31%±0.56%、6.46±0.38mmol/L、2.52±0.56、138.12±9.95g/L、6.96±0.34mg/L、7.59±0.82ng/ml),两组FINS、CP均升高,且观察组(8.61±0.38 mU/L、1.90±0.26mg/L)高于常规组(7.89±0.31mU/L、1.67±0.22 mg/L),不良妊娠结局发生率观察组(11.3%)低于常规组(32.1%)(均P<0.05)。结论:门冬胰岛素联合应用精蛋白人胰岛注射液治疗GDM,可有效改善患者血糖水平,升高HGB和CP水平,降低炎症因子水平和不良妊娠结局,临床应用效果和安全性均较好。

微小RNA 在妊娠期糖尿病发病机制及并发症中的作用

妊娠期糖尿病(gestational diabetes mellitus,GDM)是全球范围内日益严重的公共卫生问题之一,威胁着孕产妇和新生儿的健康。通过发现其病理生理机制,在预防及降低妊娠并发症的发生方面更有针对性。近年来,微小RNA(microRNA,miRNA)作为最常见的表观遗传机制之一,在妊娠相关疾病(包括GDM)的病理生理中发挥了重要作用。本综述旨在分析miRNA在GDM孕产妇中的变化,重点展示miRNA作为生物标志物对预测或诊断GDM以及预测疾病预后的潜力,更有助于探究GDM的发病机制及预防措施。

糖化血红蛋白联合血细胞比容、甲状腺功能指标对妊娠期糖尿病的诊断价值研究

目的探讨糖化血红蛋白(HbA1c)联合血细胞比容(HCT)、甲状腺功能指标[血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]对妊娠期糖尿病(GDM)的诊断价值。方法回顾性分析200例进行早期GDM筛查的孕妇临床资料,所有孕妇均进行孕12~16周HbA1c、HCT、甲状腺功能指标检查及孕中期口服葡萄糖耐量实验(OGTT)检查。比较不同检查方法的检查结果,比较孕中期OGTT正常与异常孕妇的HbA1c、HCT、甲状腺功能指标,分析孕12~16周HbA1c、HCT、甲状腺功能指标检查对GDM的诊断敏感性及特异性。结果200例孕妇进行孕12~16周HbA1c、HCT、甲状腺功能指标检查,192例正常、正常率为96.0%,8例异常、异常率为4.0%;经孕中期OGTT检查,正常183例、正常率为91.5%,17例异常、异常率为8.5%;孕12~16周HbA1c、HCT、甲状腺功能指标检查的异常率与孕中期OGTT检查比较差异无统计学意义(P>0.05)。孕中期OGTT异常者的HbA1c(9.07±0.61)%、HCT(40.41±3.23)%、TSH(4.01±0.85)mlU/L均明显高于正常者的(4.69±0.35)%、(37.72±2.98)%、(1.95±0.78)mlU/L,FT_(3)(3.68±0.54)pmol/L、FT_(4)(10.22±1.59)pmol/L均明显低于正常者的(4.52±0.73)、(14.01±1.76)pmol/L,差异具有统计学意义(P<0.05)。以孕中期OGTT检查结果为金标准,孕12~16周HbA1c、HCT、甲状腺功能指标检查对GDM的诊断敏感性及特异性分别为41.2%和99.5%。结论HbA1c联合HCT、甲状腺功能指标对GDM的早期诊断具有较高的特异性,可作为GDM患者的诊断指标。

调整空腹C肽、HbA1c及果糖胺含量对2型糖尿病患者慢性并发症发生率的影响

目的 探究以调整空腹C肽、糖化血红蛋白(HbA1c)及果糖胺含量为视角的2型糖尿病(T2DM)患者减少慢性并发症对策。方法 选择2019年3月至2020年4月收治的T2DM患者116例作为研究对象,采用随机数字表法分为对照组及观察组,均为58例。对照组给予标准糖尿病治疗和管理,观察组在对照组基础上给予调整空腹C肽、HbA1c及果糖胺含量的干预对策,2组治疗前、治疗6个月的血糖水平、胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)、空腹C肽及果糖胺含量,统计3年内慢性并发症发生情况。结果 治疗6个月,观察组FBG、2hPBG、HbA1c水平水平均低于对照组(P<0.05)。治疗6个月,观察组的BMI、HOMA-IR低于对照组(P<0.05),腰围、臀围小于对照组(P<0.05)。治疗6个月,观察组空腹C肽及果糖胺含量水平均低于对照组(P<0.05)。观察组3年内慢性并发症发生率低于对照组(P<0.05)。结论 以调整空腹C肽、HbA1c及果糖胺含量为视角的干预对策能够有效减少T2DM患者慢性并发症,改善血糖水平,改善体态,值得推广。

孕早期GDM患者血清25-OH-D、Hcy、HbA1c水平与胰岛素抵抗关系

目的:探究妊娠期糖尿病(GDM)患者孕早期血清25-羟维生素D(25-OH-D)、同型半胱氨酸(Hcy)和糖化血红蛋白(HbA1c)水平与胰岛素抵抗关系。方法:选择本院2019年12月-2022年12月收治的GDM患者134例为GDM组,同期年龄相近孕周匹配的76例正常孕妇为对照组。比较两组孕8~12周时血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、25-OH-D、Hcy、HbA1c,胰岛素抵抗指标[空腹胰岛素水平(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)],采用多因素logistic回归筛选GDM发生的危险因素,并运用Pearson相关性分析25-OH-D、Hcy、HbA1c与胰岛素抵抗关系。结果:GDM组TG、TC、LDL-C高于对照组,HDL-C低于对照组,25(OH)D(25.89±2.67nmmol/L)低于对照组(34.26±3.19 nmmol/L),Hcy(20.96±3.48μmol/L)、HbA1c(6.19%±0.31%)高于对照组(11.03±2.56μmol/L、5.67%±0.97%),FINS、HOMA-IR高于对照组,HOMA-β低于对照组;多因素分析显示,25(OH)D降低和Hcy、HbA1c、FINS、HOMA-IR上升为GDM发生的独立危险因素;Pearson相关性分析,GDM患者25-OH-D与FINS、HOMA-IR呈负相关,与HOMA-β呈正相关;Hcy及HbA1c与FINS、HOMA-IR均呈正相关,与HOMA-β均呈负相关(均P<0.05)。结论:GDM患者血清25-OH-D、Hcy、HbA1c与胰岛素抵抗密切相关,临床监测25-OH-D、Hcy、HbA1c及胰岛素抵抗情况有利于孕早期GDM防治。

糖化血红蛋白与糖化血清蛋白联合检测对早期妊娠期糖尿病的诊断效果

目的分析糖化血红蛋白和糖化血清蛋白联合检测在早期妊娠期糖尿病中的诊断价值,旨在为早期妊娠期糖尿病寻求有效的检测指标。方法以198例早期妊娠期糖尿病孕妇作为实验组,再选取同期健康孕妇200例作为对照组,两组均进行糖化血红蛋白和糖化血清蛋白检测。对比两组孕妇各项检测指标的阳性率,对比三种检测方法的灵敏度、特异度、准确性。结果实验组孕妇的糖化血红蛋白、糖化血清蛋白以及联合检测的阳性率分别为83.3%、86.9%、98.0%,明显高于对照组的12.0%、8.0%、2.0%,差异均具有统计学意义(P<0.05)。联合检测的灵敏度、特异度以及准确性分别为98.0%、98.0%、98.0%,明显高于糖化血红蛋白检测的83.3%、88.0%、85.7%和糖化血清蛋白检测的86.9%、92.0%、89.4%,差异具有统计学意义(P<0.05)。结论妊娠期糖尿病在早期可通过联合检测糖化血红蛋白和糖化血清蛋白进行评估和诊断,可显著提高诊断率,具有一定的临床价值。

个体化营养干预在妊娠期糖尿病患者中的应用效果

目的:观察个体化营养干预在妊娠期糖尿病(GDM)患者中的应用效果。方法:选取2020年2月至2022年2月该院收治的108例GDM患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各54例。对照组实施常规营养干预,研究组实施个体化营养干预。比较两组干预前后血糖指标[空腹血糖(FPG)、餐后1 h血糖(1hPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]水平、营养指标(白蛋白、血清总蛋白)水平及应对评分。结果:干预后,两组FPG、1hPG、2hPG及HbA1c水平均低于干预前,且研究组低于对照组,差异有统计学意义(P<0.05);两组白蛋白、血清总蛋白水平均高于干预前,且研究组高于对照组,差异有统计学意义(P<0.05);两组积极应对评分均高于干预前,且研究组高于对照组,两组消极应对评分均低于干预前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论:个体化营养干预应用于GDM患者,可降低血糖水平,提高营养指标水平,改善疾病应对方式,效果优于常规营养干预。

综合治疗对妊娠期糖尿病孕妇妊娠结局的影响

目的 探究妊娠期糖尿病孕妇以综合治疗方法干预对妊娠结局的影响。方法 选取2022年1月—2023年1月寿宁县医院收治的82例妊娠期糖尿病孕妇为研究对象,对其进行编号并分组,按照随机字母表法均分为对照组和观察组,各41例。对照组予以常规疗法干预,观察组予以综合治疗方法干预。对比两组孕妇干预前后血糖水平变化以及两组新生儿结局。结果 治疗后,两组患者血糖水平均明显改善,且观察组患者血糖水平明显优于对照组,差异有统计学意义(P均<0.05)。观察组新生儿不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论 妊娠期糖尿病孕妇以综合治疗方案干预有助于新生儿结局的改变,且有助于孕妇孕期控制血糖。

血清内脂素、LncRNA MALAT1、HbA1c水平与妊娠期糖尿病患者不良妊娠结局的相关性

目的:分析血清内脂素、长链非编码RNA肺腺癌转移相关转录本1(LncRNA MALAT1)、糖化血红蛋白(HbA1c)水平与妊娠期糖尿病(GDM)患者不良妊娠结局的相关性。方法:选取2021年4月至2023年4月该院收治的103例GDM患者为研究对象,纳入观察组,另选取同期于本院进行产检的103名健康孕妇为对照组,检测两组血清内脂素、LncRNA MALAT1、HbA1c水平,并随访至GDM患者分娩。比较两组、不同妊娠结局GDM患者血清内脂素、LncRNA MALAT1、HbA1c水平,并采用Pearson相关性分析血清内脂素、LncRNA MALAT1、HbA1c水平与GDM患者不良妊娠结局的相关性。结果:观察组血清内脂素、LncRNA MALAT1、HbA1c水平均高于对照组,差异有统计学意义(P<0.05);不良妊娠结局GDM患者血清内脂素、LncRNA MALAT1、HbA1c水平均高于正常妊娠结局GDM患者,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,血清内脂素、LncRNA MALAT1、HbA1c水平与GDM患者不良妊娠结局均呈正相关(r>0,P<0.05)。结论:血清内脂素、LncRNA MALAT1、HbA1c水平与GDM患者不良妊娠结局均呈正相关。