[1]张婕,任艳芳.妊娠早期血炎症指标、空腹血糖及血脂对妊娠期糖尿病的联合预测价值[J].新乡医学院学报,2024,(2):163-168.[doi:10.7683/xxyxyxb.2024.02.011]
　ZHANG Jie,REN Yanfang.Combined predictive value of inflammatory indexes,fasting plasma glucose and blood lipid in early pregnancy for gestational diabetes mellitus[J].Journal of Xinxiang Medical University,2024,(2):163-168.[doi:10.7683/xxyxyxb.2024.02.011]
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妊娠早期血炎症指标、空腹血糖及血脂对妊娠期糖尿病的联合预测价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
期数:
2024年2
页码:
163-168
栏目:
临床研究
出版日期:
2024-02-05

文章信息/Info

Title:
Combined predictive value of inflammatory indexes,fasting plasma glucose and blood lipid in early pregnancy for gestational diabetes mellitus
作者:
张婕; 任艳芳
（新乡医学院第一附属医院产科二病区，河南　卫辉　453100）
Author(s):
ZHANG Jie; REN Yanfang
(Ward II,Department of Obstetrics,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
妊娠期糖尿病; 妊娠早期; 空腹血糖; 白细胞计数; 血脂
Keywords:
gestational diabetes mellitus; early pregnancy; fasting plasma glucose; white blood cell count; blood lipid
分类号:
R587.1；R714.14
DOI:
10.7683/xxyxyxb.2024.02.011
文献标志码:
A
摘要:
目的　探讨妊娠早期（孕6~13+6周）孕妇血炎症指标、空腹血糖及血脂与妊娠期糖尿病（GDM）的关系。
方法　选择2020年11月至2021年10月在新乡医学院第一附属医院进行产检的98例妊娠早期孕妇为研究对象，依据受试者妊娠中期（孕24~28周）的口服葡萄糖耐量试验结果将其分为GDM组（n=35）和糖耐量正常（NGT）组（n=63）。所有受试者于孕6~13+6周时空腹8 h以上，于第2天清晨抽取肘正中静脉血，测定白细胞（WBC）计数、中性粒细胞计数（NC）、淋巴细胞计数（LC）、单核细胞计数（MC）、空腹血糖（FPG）及血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平，比较GDM组与NGT组孕妇各指标之间的差异。应用多因素logistic回归模型寻求联合预测因子并进行GDM发生的独立危险因素分析，采用受试者操作特征（ROC）曲线评估各危险因素预测GDM发生的效能。
结果　GDM组孕妇妊娠早期FPG、WBC计数、LC、TC、TG、LDL-C水平显著高于NGT组（P<0.05）；GDM组与NGT组孕妇的NC、MC及HDL-C水平比较差异无统计学意义（P>0.05）。Logistic回归模型分析显示， FPG、WBC计数、TC、TG升高是GDM发生的独立危险因素（P<0.05）。以FPG=4.80 mmol·L-1、WBC=9.35×109 L-1、TC=4.05 mmol·L-1、TG=1.61 mmol·L-1为截断值，预测GDM的ROC曲线下面积（AUC）分别为0.779、0.721、0.685、0.762，敏感度分别为0.886、0.514、0.857、0.543，特异度分别为0.587、0.857、0.524、0.873，四者联合预测GDM的AUC为0.876，灵敏度为0.857，特异度为0.810。妊娠早期FPG、WBC计数、TC、TG联合预测GDM的AUC高于FPG、WBC、TC、TG单独预测GDM的AUC。
结论　妊娠早期（孕6~13+6周）孕妇血FPG、WBC计数、TC、TG是GDM的独立危险因素，可作为早期预测GDM发生的临床指标，且4项指标联合对GDM有更好的预测价值。
Abstract:
Objective　To explore the relationship between inflammatory indexes,fasting plasma glucose (FPG),blood lipid in early pregnancy (6 to 13W+6D) and gestational diabetes mellitus (GDM).
Methods　Ninety-eight pregnant women in early pregnancy who underwent prenatal examinations at the First Affiliated Hospital of Xinxiang Medical University from November 2020 to October 2021 were selected as the research subjects.These pregnant women were divided into the GDM group (n=35) and normal glucose tolerance (NGT) group (n=63) according to the oral glucose tolerance test results in the second trimester of pregnancy (24-28W).All subjects kept fasting for at least 8 hours at 6 to 13W+6D of pregnancy,and the blood was collected from the median cubital vein on the morning of the second day,the white blood cell (WBC) count,neutrophil count (NC),lymphocyte count (LC),monocyte count (MC),FPG,and serum total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were measured.The differences in various indicators of pregnant women between the GDM group and NGT group were compared.The joint predictive factors for GDM was obtained by multivariable logistic regression model,and the independent risk factors of GDM were analyzed,and the efficiency of each risk factor in predicting the occurrence of GDM was evaluated by the receiver operating characteristic (ROC) curve.
Results　The FPG,WBC,LC,TC,TG and LDL-C levels of pregnant women in the GDM group were significantly higher than those in the NGT group in early pregnancy (P<0.05);there was no significant difference in the NC,MC and HDL-C levels of pregnant women between the two groups (P>0.05).Logistic regression model analysis results showed that the increase of FPG,WBC,TC and TG were independent risk factors affecting the occurrence of GDM (P<0.05).Taking FPG=4.80 mmol·L-1,WBC=9.35×109 L-1,TC=4.05 mmol·L-1 and TG=1.61 mmol·L-1 as cut-off values,the area under the curve (AUC) of above indexes in predicting GDM were 0.779,0.721,0.685 and 0.762,respectively;the sensitivity was 0.886,0.514,0.857 and 0.543,respectively;the specificity was 0.587,0.857,0.524 and 0.873,respectively.The AUC of the combined prediction of FPG,WBC,TC and TG for GDM was 0.876,with a sensitivity of 0.857 and a specificity of 0.810.The AUC of the combined prediction of FPG,WBC,TC and TG for GDM was significantly higher than that of FPG,WBC,TC and TG in early pregnancy alone for GDM.
Conclusion　Elevated levels of FPG,WBC,TC and TG in early pregnancy (6 to 13W+6D) are independent risk factors for GDM,and they can be used as clinical indicators for the early prediction of GDM.The combination of the four indicators has better predictive value for GDM.

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更新日期/Last Update: 2024-02-05