The 0.1% of the Population With Glucokinase Monogenic Diabetes Can Be Recognized by Clinical Characteristics in Pregnancy: The Atlantic Diabetes in Pregnancy Cohort
The 0.1% of the Population With Glucokinase Monogenic Diabetes Can Be Recognized by Clinical Characteristics in Pregnancy: The Atlantic Diabetes in Pregnancy Cohort
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DOI：
10.2337/dc13-2248
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发表时间：
2014-05-01
期刊：
影响因子：
16.2
通讯作者：
Dunne, Fidelma P.
中科院分区：
文献类型：
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作者：
Chakera, Ali J.;Spyer, Gill;Dunne, Fidelma P.
目的识别妊娠期葡萄糖激酶单基因糖尿病 (GCK-MODY) 非常重要，因为治疗方法与其他形式妊娠糖尿病 (GDM) 的治疗方法不同，并且不会增加孕产妇患 2 型糖尿病的风险。我们计算了妊娠期 GCK-MODY 的人群患病率，并确定了将患有 GCK-MODY 的孕妇与 GDM 孕妇区分开来的临床特征。 研究设计和方法我们通过测试基于人群的大西洋妊娠期糖尿病 (Atlantic DIP) 研究 (n = 5,500) 的一部分患者，计算了妊娠期 GCK-MODY 的人群患病率。我们对 247 名空腹血糖为 5.1 mmol/L 的女性和 109 名随机选择的空腹血糖正常的对照受试者进行了 GCK 突变测序。利用发现的病例数据和 40 例先前确定的 GCK-MODY 妊娠，我们分析了是否可以使用临床标准来区分 GCK-MODY 和 GDM。 结果 4 名空腹血糖为 5.1 mmol/L 的女性被诊断为 GCK-MODY。没有发现空腹血糖正常的病例。 GCK-MODY 的人群患病率为 1.1/1,000 人（95% CI 0.3-2.9/1,000），GDM 患病率为 0.9%（95% CI 0.3-2.3）。空腹血糖和 BMI 显着区分 GCK-MODY 和 GDM (P < 0.0001)。 BMI综合标准
OBJECTIVEIdentifying glucokinase monogenic diabetes (GCK-MODY) in pregnancy is important, as management is different from management for other forms of gestational diabetes mellitus (GDM) and there is no increased maternal risk of type 2 diabetes. We calculated the population prevalence of GCK-MODY in pregnancy and determined the clinical characteristics that differentiate pregnant women with GCK-MODY from those with GDM.RESEARCH DESIGN AND METHODSWe calculated the population prevalence of GCK-MODY in pregnancy by testing a subset of patients from the population-based Atlantic Diabetes in Pregnancy (Atlantic DIP) study (n = 5,500). We sequenced for GCK mutations in 247 women with a fasting glucose 5.1 mmol/L and 109 randomly selected control subjects with normal fasting glucose. Using data from the cases found and 40 previously identified GCK-MODY pregnancies, we analyzed whether clinical criteria could be used to differentiate GCK-MODY from GDM.RESULTSFour women with fasting glucose 5.1 mmol/L were diagnosed with GCK-MODY. No cases were identified with normal fasting glucose. The population prevalence of GCK-MODY is 1.1 in 1,000 (95% CI 0.3-2.9 in 1,000) and prevalence in GDM is 0.9% (95% CI 0.3-2.3). Fasting glucose and BMI significantly differentiate GCK-MODY from GDM (P < 0.0001). Combined criteria of BMI