TOTAL SERUM GLYCOSYLATED PROTEINS IN DETECTION AND MONITORING OF GESTATIONAL DIABETES
TOTAL SERUM GLYCOSYLATED PROTEINS IN DETECTION AND MONITORING OF GESTATIONAL DIABETES
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DOI：
10.2337/diacare.13.8.872
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发表时间：
1990-08-01
期刊：
影响因子：
16.2
通讯作者：
PERNOLL, ML
中科院分区：
文献类型：
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作者：
CEFALU, WT;PRATHER, KL;PERNOLL, ML
本研究的目的是确定血清糖基化蛋白水平（即果糖胺）是否可以可靠地筛查妊娠糖尿病，以及这些水平是否可以作为妊娠晚期短期血糖控制的有效标志。对97名妊娠26-28周的孕妇进行了9个月的评估。在基线静脉穿刺进行100克口服葡萄糖耐量试验以检测妊娠糖尿病时测定HbA1c和血清糖化蛋白（血清果糖胺）。在研究的97名妇女中，13名被检测为妊娠糖尿病阳性（国家糖尿病数据组标准）。非糖尿病患者与糖尿病患者空腹及1、2、3小时血糖值差异均有统计学意义（各时间点P < 0.005）。基线血清糖化蛋白水平(2.02 .+-。0.08 vs. 1.98。0.02 mM， NS)或HbA1c水平(4.42 .+-。0.2 vs. 4.6。0.3%， NS)，妊娠期和非糖尿病患者。每隔2周对糖尿病患者进行随访，通过门诊监测测定血清糖化蛋白分析、糖化血红蛋白、空腹血糖和平均血糖。2周随访时，血清糖化蛋白与空腹血糖（r = 0.81, P < 0.001）和平均门诊血糖（r = 0.62, P < 0.001）显著相关。随访期间，HbA1c与空腹血糖（r = 0.11， NS）或平均门诊血糖（r = -0.12， NS）无相关性。血清糖化蛋白水平（血清果糖胺）不是一个有用的筛查试验妊娠糖尿病。然而，该试验显示了作为评估母体血糖状态短期控制的客观标记物的潜力。
The goal of this study was to determine whether serum glycosylated protein levels (i.e., fructosamine) can reliably screen for gestational diabetes and whether these levels are valid markers of short-term glycemic control in the third trimester of pregnancy. Ninety-seven pregnant women at 26-28 wk gestation were evaluated over 9 mo. HbA1c and serum glycosylated protein (serum fructosamine) were determined at the baseline venipuncture of the 100-g oral glucose tolerance test performed to detect gestational diabetes. Of the 97 women studied, 13 tested positive for gestational diabetes (National Diabetes Data Group criteria). There were significant differences in the fasting and 1-, 2-, and 3-h glucose values between nondiabetic and diabetic patients (P < 0.005 at each time point). No difference was noted in the baseline serum glycosylated protein level (2.02 .+-. 0.08 vs. 1.98 .+-. 0.02 mM, NS) or HbA1c level (4.42 .+-. 0.2 vs. 4.6 .+-. 0.3%, NS) between gestational and nondiabetic patients. Diabetic patients were followed at 2-wk intervals, with serum glycosylated protein analysis, HbA1c, fasting glucose, and mean glucose determined by outpatient monitoring. Serum glycosylated protein correlated significantly to fasting blood glucose (r = 0.81, P < 0.001) and mean outpatient glucose (r = 0.62, P < 0.001) at the 2-wk follow-up visits. No correlation was found between HbA1c and fasting blood glucose (r = 0.11, NS) or mean outpatient glucose (r = -0.12, NS) during the follow-up period. The serum glycosylated protein level (serum fructosamine) is not a useful screening test for gestational diabetes. However, this assay shows potential as an objective marker of short-term control in evaluating the maternal glycemic state.