Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population
Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population
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DOI：
10.1111/j.1464-5491.2009.02765.x
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发表时间：
2009-08-01
影响因子：
3.5
通讯作者：
Gupta, R.
中科院分区：
文献类型：
--
作者：
Agarwal, M. M.;Dhatt, G. S.;Gupta, R.
目的在妊娠期糖尿病(GDM)的高危人群中，通过口服葡萄糖耐量试验(OGTT)对每个孕妇进行筛查是非常困难的。本研究旨在探讨空腹毛细血管血糖(FCG)作为妊娠期糖尿病(GDM)筛查指标的价值。方法采用血浆相关血糖仪测定1465例孕妇的FCG，并对其进行一步诊断性75g口服葡萄糖耐量试验(OGTT)。FCG的受试者工作特征曲线下面积(AUC)为0.83(95%可信区间0.80~0.86)。FCG阈值为4.7 mmol/L(在可接受的敏感度为86.0%时)可单独排除731例(49.9%)GDM，而FCG可排除16例(1.1%)GDM(100%特异性)；因此，大约一半的妇女不需要继续进行繁琐的OGTT。更广泛的评估，特别是在低风险人群中，将确认FCG作为GDM筛查试验的潜在价值。
AimsIn populations at high risk of gestational diabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM.MethodsFCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g OGTT for universal screening of GDM.ResultsOne hundred and ninety-six (13.4%) women had GDM as defined by the criteria of the American Diabetes Association. The area under the receiver operating characteristic curve (AUC) of the FCG was 0.83 (95% confidence interval 0.80-0.86). A FCG threshold of 4.7 mmol/l (at an acceptable sensitivity of 86.0%) independently could rule-out GDM in 731 (49.9%) women, while the FCG could rule-in GDM (100% specificity) in 16 (1.1%) additional women; therefore, approximately half of the women would not need to continue with the cumbersome OGTT.ConclusionsScreening using a FCG significantly reduces the number of OGTTs needed for the diagnosis of GDM. Wider assessment, particularly in low-risk populations, would confirm the potential value of the FCG as a screening test for GDM.