Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks
Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks
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DOI：
10.1002/pd.2636
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发表时间：
2011-02-01
影响因子：
3
通讯作者：
Nicolaides, Kypros H.
中科院分区：
文献类型：
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作者：
Nanda, Surabhi;Savvidou, Mina;Nicolaides, Kypros H.
目的建立妊娠期糖尿病（GDM）的预测模型，方法对11 464例妊娠期糖尿病（GDM）孕妇进行前瞻性筛查，其中297例（2.6%）为GDM患者，建立基于孕妇特征的GDM预测模型。采用病例对照研究方法，检测80例GDM孕妇血清脂联素、卵泡抑素样蛋白3（FSTL 3）和性激素结合球蛋白（SHBG）水平。在GDM组中，与对照组相比，正常中位数脂联素（0.66; IQR：0.5-0.9 vs 1.02; IQR：0.7-1.29）和SHBG（0.81; IQR：0.6-1.04 vs 1.02; IQR：0.8-1.2）的中位数倍数较低（p < 0.05），但FSTL 3无显著差异。孕妇特征筛查GDM的检出率为61.6%，假阳性率为20%，加入脂联素和SHBG后，GDM的检出率提高到74.1%。版权所有（C）2010约翰威利父子有限公司
Objective To develop a model for the prediction of gestational diabetes mellitus (GDM) from maternal characteristics and biochemical markers at 11 to 13 weeks' gestation.Methods A prospective screening study on early prediction of pregnancy complications (n = 11, 464), including 297 (2.6%) cases of GDM was used to create the predictive model of GDM based on maternal characteristics. Maternal serum concentrations of adiponectin, follistatin-like-3 (FSTL3) and sex hormone-binding globulin (SHBG) were measured in a case-control study of 80 women who developed GDM and 300 controls.Results In the screening study, maternal age, body mass index, racial origin, previous history of GDM and macrosomic neonate were significant independent predictors of future GDM. In the GDM group, compared to controls, the median multiple of the normal median adiponectin (0.66; IQR: 0.5-0.9 vs 1.02; IQR: 0.7-1.29) and SHBG (0.81; IQR: 0.6-1.04 vs 1.02; IQR: 0.8-1.2) was lower (p < 0.05), but FSTL3 was not significantly different. In screening for GDM by maternal characteristics, the detection rate was 61.6% at a false-positive rate of 20% and the detection increased to 74.1% by the addition of adiponectin and SHBG.Conclusion First-trimester screening for GDM can be provided by a combination of maternal characteristics and biomarkers. Copyright (C) 2010 John Wiley & Sons, Ltd.