Nomograms for incident risk of post-partum type 2 diabetes in Chinese women with prior gestational diabetes mellitus.
Nomograms for incident risk of post-partum type 2 diabetes in Chinese women with prior gestational diabetes mellitus.
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既往患有妊娠期糖尿病的中国女性产后 2 型糖尿病发生风险列线图
DOI：
10.1111/cen.13863
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发表时间：
2019-03
影响因子：
3.2
通讯作者：
Mi J
中科院分区：
文献类型：
--
作者：
Li W;Leng J;Liu H;Zhang S;Wang L;Hu G;Mi J
咨询妊娠期糖尿病(GDM)患者产后2型糖尿病(T2D)的个体风险是具有挑战性的。这项研究旨在开发诺模图来预测符合WHO1998标准诊断为妊娠期糖尿病的妇女产后T2D的发生风险。我们对1263名患有妊娠期糖尿病的中国妇女进行了一项回顾性队列研究，其中83人在产后2.3年被诊断为T2D。多因素COX比例风险模型用于研究产后T2D的独立预测因素。多变量分析的结果被用来制定预测产后T2D事件风险的诺模图。用受试者工作特征曲线下面积(AUROC)评价预测的准确性。多因素分析显示，糖尿病家族史[危险比及其95%可信区间(95%CI)：2.06(95%CI：1.32~3.22)]、妊娠高血压病史[3.11(95%CI：1.86~5.21)]、孕前BMI[1.00、1.90(95%CI：1.14~3.16)、3.67(95%CI：2.03~6.63)]是妊娠期糖尿病的独立预测因素；24、24~28和≥28 kg/m~2]，孕26~30周2小时血糖分别为1.00、2.84(95%CI：1.42~5.69)和9.42(95%CI：4.46~19.90)。产后2年和3年T2D的AUROC分别为85.9%(95%CI：79.7%−92.1%)和83.2%(95%CI：77.9%−88.6%)。这一易于使用的诺模图具有非侵入性的临床特征，可以准确地预测GDM妇女产后T2D的风险。它可以促进患者和临床医生之间的风险沟通。
Counseling patients with gestational diabetes mellitus (GDM) on their individual risk of postpartum type 2 diabetes (T2D) is challenging. This study aimed to develop nomograms for predicting incident risk of postpartum T2D in women with GDM diagnosed by WHO1998 criteria. We performed a retrospective cohort study in 1,263 Chinese women with GDM, of whom 83 were diagnosed as T2D at 2.3 years postpartum. Multivariate Cox proportional hazards models were used to investigate the independent predictors for postpartum T2D. The results of multivariate analyses were used to formulate nomograms for predicting incident risk of postpartum T2D. The predictive accuracy was evaluated using the area under the receiver operating characteristic curve (AUROC). On multivariate analysis, independent predictors of postpartum T2DM in women with GDM included family history of diabetes [hazard ratio (HR) and its 95% confidential interval (95%CI): 2.06 (95%CI: 1.32–3.22)], history of pregnancy-induced hypertension [3.11 (95%CI: 1.86–5.21)], pre-pregnancy BMI [1.00, 1.90 (95%CI: 1.14–3.16), and 3.67 (95%CI: 2.03–6.63) for BMI <24, 24–28, and ≥28 kg/m2], and 2-hour glucose at 26–30 gestational weeks [1.00, 2.84 (95%CI: 1.42–5.69), and 9.42 (95%CI: 4.46–19.90) for 2 hour glucose at 7.8 ~ <8.5, 8.5 ~ <11.1, and ≥11.1 mmol/L). The overall AUROC of nomogram was 82.8% (95%CI: 78.1%−87.5%), with AUROCs of 85.9% (95%CI: 79.7%−92.1%) and 83.2% (95%CI: 77.9%−88.6%) for postpartum 2-year and 3-year risk of T2D, respectively. This easy-to-use nomogram, with noninvasive clinical characteristics, can accurately predict the risk of postpartum T2D in women with GDM. It may facilitate risk communication between patients and clinicians.
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影响因子：
16.8
作者：
Tilgner, Hagen;Nikolaou, Christoforos;Guigo, Roderic
通讯作者：
Guigo, Roderic
影响因子：
5.1
作者：
Hu, Gang;Tian, Huiguang;Tuomilehto, Jaakko
通讯作者：
Tuomilehto, Jaakko
影响因子：
5.1
作者：
Cho, N. H.;Shaw, J. E.;Malanda, B.
通讯作者：
Malanda, B.
影响因子：
8.2
作者：
Chien, K.;Cai, T.;Hu, F. B.
通讯作者：
Hu, F. B.
DOI：
10.1016/s1470-2045(14)71116-7
发表时间：
2015-04
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Balachandran VP;Gonen M;Smith JJ;DeMatteo RP
通讯作者：
DeMatteo RP