Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations of maternal A1C and glucose with pregnancy outcomes.
Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations of maternal A1C and glucose with pregnancy outcomes.
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DOI：
10.2337/dc11-1687
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发表时间：
2012-03
期刊：
影响因子：
16.2
通讯作者：
HAPO Study Cooperative Research Group
中科院分区：
文献类型：
--
作者：
Lowe LP;Metzger BE;Dyer AR;Lowe J;McCance DR;Lappin TR;Trimble ER;Coustan DR;Hadden DR;Hod M;Oats JJ;Persson B;HAPO Study Cooperative Research Group
在多国高血糖和不良妊娠结局（HAPO）研究中，比较母体葡萄糖和A1C与不良结局的关系，并在这些比较的基础上确定A1C测量是否可以为孕妇提供口服葡萄糖耐量试验（OGTT）的替代方案。符合条件的孕妇在妊娠24-32周接受75克OGTT。同时采集糖化血红蛋白样本。测定新生儿人体测量学和脐带血清c肽。使用多重逻辑回归评估与结果的关联，并对潜在混杂因素进行调整。在23316名血糖水平对护理人员不知情的HAPO研究参与者中，21064人的A1C结果无变异。平均±SD A1C为4.79±0.40%。与糖化血红蛋白相比，糖化血红蛋白与出生体重、皮肤褶皱总数、体脂百分比（第90百分位数）以及空腹和1小时血糖与脐带c肽的相关性显著增强（均P < 0.01）。例如，在完全调整后的模型中，对于空腹、1小时、2小时血糖和糖化血红蛋白，每增加1个标准差，出生体重的比值比（ORs）为1.39、1.45和1.38，而对于糖化血红蛋白，比值比分别为1.15。脐带c肽bb0第90百分位数的or分别为葡萄糖1.56、1.45和1.35，糖化血红蛋白1.32。原发性剖宫产、先兆子痫和早产的血糖和糖化血红蛋白or相似。基于与不良结果的关联，这些发现表明，在孕妇中，A1C测量并不是OGTT的有效替代。
To compare associations of maternal glucose and A1C with adverse outcomes in the multinational Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and determine, based on those comparisons, if A1C measurement can provide an alternative to an oral glucose tolerance test (OGTT) in pregnant women. Eligible pregnant women underwent a 75-g OGTT at 24–32 weeks’ gestation. A sample for A1C was also collected. Neonatal anthropometrics and cord serum C-peptide were measured. Associations with outcomes were assessed using multiple logistic regression with adjustment for potential confounders. Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, 21,064 had a nonvariant A1C result. The mean ± SD A1C was 4.79 ± 0.40%. Associations were significantly stronger with glucose measures than with A1C for birth weight, sum of skinfolds, and percent body fat >90th percentile and for fasting and 1-h glucose for cord C-peptide (all P < 0.01). For example, in fully adjusted models, odds ratios (ORs) for birth weight >90th percentile for each measure higher by 1 SD were 1.39, 1.45, and 1.38, respectively, for fasting, 1-, and 2-h plasma glucose and 1.15 for A1C. ORs for cord C-peptide >90th percentile were 1.56, 1.45, and 1.35 for glucose, respectively, and 1.32 for A1C. ORs were similar for glucose and A1C for primary cesarean section, preeclampsia, and preterm delivery. On the basis of associations with adverse outcomes, these findings suggest that A1C measurement is not a useful alternative to an OGTT in pregnant women.
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影响因子：
16.2
作者：
通讯作者：
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DOI：
10.1016/s0002-9378(11)91719-0
发表时间：
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作者：
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