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目的探讨妊娠早期FPG对GDM的预测价值。方法回顾性分析2014年于上海市第六人民医院金山分院产检和住院孕妇妊娠早期FPG水平,以及妊娠24~28周75 g OGTT资料;根据妊娠早期FPG水平对行OGTT的孕妇进行四分位分组,比较并分析妊娠早期FPG与OGTT不同时点血糖及GDM关系。结果 2165名孕妇中GDM 248例;GDM组妊娠早期FPG水平高于非GDM组[(4.86±0.48)vs(4.67±0.32)mmol/L,P<0.01];仅用FPG诊断GDM患病率四分位组比较,差异有统计学意义(P<0.01),仅用1 hPG或2 hPG诊断GDM患病率四分位组比较,差异无统计学意义(P>0.05)。相关分析显示,妊娠早期FPG与妊娠中期FPG呈正相关(r=0.497,P<0.01)。妊娠早期FPG预测仅用FPG诊断的GDM受试者工作特征(ROC)曲线下最大面积(AUC)为0.834(95%CI:0.796~0.871,P<0.01),切点为5.05 mmol/L,敏感性66.7%,特异性88.4%。结论上海朱泾地区孕妇GDM患病率为11.45%;仅以妊娠早期FPG预测GDM能力较低。
Objective To investigate the predictive value of early gestational FPG on GDM. Methods The levels of FPG in prenatal and postnatal pregnancies of Jinshan Branch of Shanghai Sixth People’s Hospital in 2014 were analyzed retrospectively. The data of 75 g OGTT from 24 to 28 weeks of gestation were analyzed retrospectively. Pregnant women with OGTT were divided into quartiles , And compared and analyzed the relationship between blood glucose and GDM at different time points of FPG and OGTT in early pregnancy. Results GMI group had 248 cases of GDM in pregnant women, and FPG level in early pregnancy in GDM group was higher than that in non-GDM group [(4.86 ± 0.48) vs (4.67 ± 0.32) mmol / L, P <0.01] The difference was statistically significant (P <0.01). There was no significant difference in the incidence of GDM with 1 hPG or 2 hPG in the quartile group (P> 0.05). Correlation analysis showed that FPG in early pregnancy was positively correlated with FPG in the second trimester (r = 0.497, P <0.01). The maximum area under curve (ROC) of 0.849 (95% CI: 0.796-0.871, P <0.01) and the cutoff point of 5.05 mmol / L were sensitive to FPG prediction in FPG-only GDM subjects Sex 66.7%, specificity 88.4%. Conclusion The prevalence of GDM in pregnant women in Zhujing area of Shanghai is 11.45%. The ability of GDM to predict FPG only in early pregnancy is low.