Correspondence between first-trimester fasting glycaemia, and oral glucose tolerance test in gestational diabetes diagnosis
Correspondence between first-trimester fasting glycaemia, and oral glucose tolerance test in gestational diabetes diagnosis
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DOI：
10.1016/j.diabet.2012.03.006
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发表时间：
2012-11-01
影响因子：
7.2
通讯作者：
Di Benedetto, A.
中科院分区：
文献类型：
--
作者：
Corrado, F.;D'Anna, R.;Di Benedetto, A.
瞄准。-评价妊娠早期空腹血糖与糖耐量试验结果在诊断妊娠期糖尿病中的相关性。--回顾了过去一年中所有连续接受诊断OGTT的妇女的医疗记录，这些妇女根据IADPSG进行了检查。所有妊娠早期空腹血糖值均大于或等于5.1mmo1/L(92 mg/dL)，建议作为诊断值，也为该队列中的每个患者进行了验证。建立ROC曲线和多元Logistic回归模型，计算该临界值对GDM诊断的预测能力。-在我们738名符合条件的孕妇中，OGTT显示GDM的患病率为11.9%。然而，当回顾每个患者的妊娠早期空腹血糖值时，还有29名患者尽管OGTT正常，但仍应被诊断为GDM患者(血糖和GT=5.1 mmol/L)。然而，当空腹血糖的值被认为不是诊断，而只是预测时，与参照组(空腹血糖)相比，这些患者的AUC值为0.614(95%可信区间：0.544-0.684)，AOR7.1(95%可信区间：3.813.1)
Aim. - To evaluate the correspondence between first-trimester fasting glycaemia and the results of the OGTT in diagnosing gestational diabetes (GDM).Methods. - The medical records of all consecutive women who had undergone a diagnostic OGTT, performed according to the IADPSG, during the past year were retrospectively reviewed. All first-trimester fasting glucose values greater or equal to 5.1 mmol/L (92 mg/dL), recommended as a diagnostic value, were also verified for each patient in this cohort. Moreover, a ROC curve and a multiple logistic-regression model were constructed to calculate the predictive capability of this cut-off value in diagnosing GDM.Results. - In our population of 738 eligible pregnant women, an 11.9% prevalence of GDM was revealed by OGTT. However, when the first-trimester fasting glucose value for each patient was retrospectively considered, there were a further 29 patients who should have been diagnosed as GDM cases (glycaemia >= 5.1 mmol/L), although their OGTT was normal. Yet, when the value of fasting glucose was considered not diagnostic, but only predictive, an AUC of 0.614 (95% CI: 0.544-0.684) and an aOR of 7.1 (95% CI: 3.8-13.1) was obtained in these patients compared with the reference group (fasting glucose