High probability of false-positive gestational diabetes mellitus diagnosis during early pregnancy
High probability of false-positive gestational diabetes mellitus diagnosis during early pregnancy
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DOI：
10.1136/bmjdrc-2020-001234
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发表时间：
2020-01-01
影响因子：
4.1
通讯作者：
Miyagi, Etsuko
中科院分区：
文献类型：
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作者：
Nakanishi, Sayuri;Aoki, Shigeru;Miyagi, Etsuko
本研究旨在评估应用国际糖尿病与妊娠研究组协会（IADPSG）标准诊断妊娠期糖尿病（GDM）的有效性。研究设计和方法本多中心队列研究于2018年1月至2019年4月在日本5家机构进行。研究队列包括妊娠早期符合以下一项或多项IADPSG标准的GDM高危女性：空腹血糖（FPG）≥ 92 mg/dL，75 g口服葡萄糖耐量试验（OGTT）1小时值≥ 180 mg/dL，或2小时值≥ 153 mg/dL（以下称为早发性GDM）。诊断为早发性GDM的妇女在没有治疗干预的情况下进行随访，并在妊娠24-28周期间再次接受75 g OGTT。那些表现出GDM模式的第二个75克OGTT诊断为真正的GDM和治疗，而那些表现出正常的模式被诊断为假阳性早期GDM，并没有接受任何治疗intervention.Results的146名妇女诊断为早发性GDM，69（47%）有正常的75克OGTT值在24-28周的妊娠，表明假阳性结果。第一次75 g OGTT试验中的FPG水平显著高于第二次75 g OGTT试验（分别为93 mg/dL和87.5 mg/dL; p
Introduction This study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy.Research design and methods This multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) >= 92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of >= 180 mg/dL at 1 hour, or >= 153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24-28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention.Results Of the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24-28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p