Longitudinal changes in the continuous glucose profile measured by the CGMS® in healthy pregnant women and determination of cut-off values
Longitudinal changes in the continuous glucose profile measured by the CGMS® in healthy pregnant women and determination of cut-off values
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DOI：
10.1016/j.ejogrb.2007.12.006
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发表时间：
2008-07-01
影响因子：
2.6
通讯作者：
Buhling, Kai J.
中科院分区：
文献类型：
--
作者：
Siegmund, Tina;Rad, Neda Talai;Buhling, Kai J.
目标：这项纵向研究对不同胎龄的健康正常体重孕妇的每日血糖水平进行了连续评估，并确定了正常水平。32名健康正常体重孕妇于16、22、24、25、26、27、28、29、29孕龄30周和36周以及分娩后6周。所有观察均在Charite医院门诊进行。用CGMS获得的每日血糖水平曲线提供了24小时内餐前和餐后血糖水平和平均血糖值。卡路里的摄入量是通过详细的食物日志来确定的。此外，每次访视时还进行胎儿生物测量和母体体重测量。使用斯皮尔曼检验检验相关性。结果：研究对象的平均年龄为29.6 +/-4.5。平均孕前BMI为22.4 +/-2.5 kg/M2。这些婴儿平均在怀孕第40周出生。平均热量摄入量为2223 +/-356千卡。在研究过程中未观察到热量摄入的显著变化。血糖水平在整个妊娠过程中显著升高，从妊娠第30周的4.84 +/-0.4 mmolA（87.2 +/-7.2 mg/dl）升高至第36周的5.22 +/-0.5 mmolA（94.0 +/-9.0 mg/dl）（p = 0.002）。产后水平为5.20 ± 0.5 mmolA（93.7 ± 9.0 mg/dl）（p = 0.51）。空腹血糖水平在怀孕期间没有变化。一个值得注意的方面是产后空腹水平显著增加，为5.02 +/-0.6 mmol/l（90.4 +/-10.8 mg/dl）（p = 0.00）。餐后血糖水平分析证实，从5.30 +/-0.6 mmol/l（95.5 +/-10.8 mg/dl），第16周降至6.14 +/-0.7 mmol/l（110.6 +/-12.6 mg/dl），出生后降至5.59 +/-0.6 mmol/l（100.7 +/-10.8 mg/dl）。这些测量是适应孕龄。结论：连续测量血糖水平上升，尽管正常的孕前代谢和不变的碳水化合物的摄入量在妊娠期间在健康的孕妇。这些结果表明，有必要的孕龄依赖性的截止值。(C)2008爱思唯尔爱尔兰有限公司保留所有权利。
Objective: This longitudinal study performed continuous evaluation of daily blood glucose level profiles in healthy normal-weight pregnant patients during various gestational age and determined normal levels.Study design: Thirty-two healthy normal-weight pregnant women received a continuous glucose monitoring system (CGMS (R)) device for periods of 72 h in the 16th, 22nd, 30th and 36th weeks of gestational age and at 6 weeks after delivery. All observations took place in the outpatient clinic of the Charite hospital. The daily blood glucose level profiles obtained with the CGMS provided pre- and postprandial blood glucose levels and a mean glucose value for a 24-h period. Caloric intake was determined using detailed food logs. Additionally, a fetal biometry and an measurement of maternal weight were performed at each visit. The correlation was tested using Spearman's test.Results: The average age of the study subjects was 29.6 +/- 4.5. Average pre-pregnancy BMI was 22.4 +/- 2.5 kg/M2. The births occurred on average in the 40th week of pregnancy. Average caloric intake was 2223 +/- 356 kcal. No significant changes in caloric intake were observed during the course of the study. The blood glucose levels showed a significant rise throughout the course of the pregnancy, going from 4.84 +/- 0.4 mmolA (87.2 +/- 7.2 mg/dl) during the 30th week of pregnancy to 5.22 +/- 0.5 mmolA (94.0 +/- 9.0 mg/dl) during the 36th week (p = 0.002). Postpartum levels were 5.20 +/- 0.5 mmolA (93.7 +/- 9.0 mg/dl) (p = 0.51). Fasting blood glucose levels did not change during the course of the pregnancy. A noticeable aspect were the significantly increased fasting postpartum levels with 5.02 +/- 0.6 mmol/l (90.4 +/- 10.8 mg/dl) (p = 0.00). Analysis of the postprandial glucose levels confirmed a rise from 5.30 +/- 0.6 mmol/l (95.5 +/- 10.8 mg/dl) in the 16th week to 6.14 +/- 0.7 mmol/l (110.6 +/- 12.6 mg/dl) in the fourth study phase (36th week), and a decrease after the birth to 5.59 +/- 0.6 mmol/l (100.7 +/- 10.8 mg/dl). These measurements were adapted to the gestational age.Conclusion: Continuous measured glucose levels rose during the pregnancy in healthy pregnant women in spite of normal pre-pregnancy metabolism and unchanged carbohydrate intake during gestation. These results suggest the necessity of gestational-age-dependent cut-off values. (C) 2008 Elsevier Ireland Ltd. All rights reserved.