Prevalence and risk factors of gestational diabetes in Punjab, North India: results from a population screening program
Prevalence and risk factors of gestational diabetes in Punjab, North India: results from a population screening program
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DOI：
10.1530/eje-14-0428
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发表时间：
2015-08-01
影响因子：
5.8
通讯作者：
Vaag, Allan A.
中科院分区：
文献类型：
--
作者：
Arora, Geeti P.;Thaman, Richa G.;Vaag, Allan A.
目的：2013年，世界卫生组织（WHO）改变了妊娠期糖尿病（GDM）的诊断标准，承认空腹血糖（FPG）水平轻度升高对妊娠结局的推定影响。我们的目的是确定GDM的患病率和危险因素，将以前的WHO 1999标准与WHO 2013标准在印度北部进行比较。在一项基于人群的筛查计划中，随机选择了5100名北印度妇女，采用横断面设计和问卷调查进行了研究，静脉FPG和2小时毛细血管血浆葡萄糖（PG）后，75克口服葡萄糖耐量试验进行了24和28周的怀孕。根据WHO 2013年标准，GDM的患病率为35%，而根据WHO 1999年标准，GDM的患病率为9%。FPG测量确定了94%的WHO 2013 GDM病例，而WHO 1999 GDM病例为11%。相比之下，2小时PG测量仅确定了WHO 2013 GDM病例的13%，而WHO 1999 GDM病例的96%。使用Logistic回归后向消除，城市居住地，文盲，非素食主义，BMI增加，印度教宗教和低成人身高都是使用1999年标准的GDM的独立危险因素，而只有城市居住地，低成人身高和年龄增加是使用2013年标准的GDM的独立危险因素。需要进行干预研究，以证明世卫组织2013年GDM标准的合理性，该标准将患病率提高了四倍，以包括三分之一以上的北印度孕妇。
Objective: The World Health Organization (WHO) has in 2013 changed the diagnostic criteria for gestational diabetes mellitus (GDM) to acknowledge the putative effect of mildly elevated fasting plasma glucose (FPG) levels on pregnancy outcomes. We aimed to determine the prevalence and risk factors of GDM comparing the previous WHO 1999 criteria to the WHO 2013 criteria in North India.Methods: In a population-based screening programme, 5100 randomly selected North Indian women were studied using a cross-sectional design with a questionnaire, venous FPG and 2-h capillary plasma glucose (PG) after a 75 g oral glucose tolerance test performed between 24 and 28 weeks of pregnancy.Results: The prevalence of GDM was 35% using WHO 2013 criteria vs 9% using WHO 1999 criteria. FPG measurements identified 94% of WHO 2013 GDM cases as opposed to 11% of WHO 1999 GDM cases. In contrast, 2-h PG measurements identified only 13% of WHO 2013 GDM cases compared with 96% of the WHO 1999 GDM cases. Using logistic regression with backward elimination, urban habitat, illiteracy, non-vegetarianism, increased BMI, Hindu religion and low adult height were all independent risk factors of GDM using the 1999 criteria, whereas only urban habitat, low adult height and increased age were independent risk factors of GDM using the 2013 criteria.Conclusions: Intervention studies are needed to justify the WHO 2013 GDM criteria increasing the prevalence four fold to include more than one third of North Indian pregnant women.