在怀孕12至16周的口服葡萄糖耐受性测试中,与血葡萄糖度相关的第一季度HbA1c - - 一项基于人口的研究
Mervi Jokelainen1,2, Hannu Kautiainen3,4, Arja Nenonen5
1Obstetrics and Gynecology, South Karelia Central Hospital, Valto Käkelän katu 1, Lappeenranta, 53130, Finland.
Diabetology & metabolic syndrome
|February 28, 2024
概括
怀孕早期的HbA1c水平可以帮助识别患有妊娠糖尿病 (GDM) 风险较高的女性. 这一发现支持使用HbA1c来早期查GDM在头三个月.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 围产儿医学 围产儿医学
背景情况:
- 孕期糖尿病 (GDM) 往往需要治疗,并且与不良的围产期结果有关.
- 识别需要早期GDM查的妇女至关重要,但目前的方法不足.
研究的目的:
- 评估HbA1c在口服葡萄糖耐受性测试 (OGTT) 期间预测高血葡萄糖水平的诊断准确性.
- 评估HbA1c能够预测药理治疗早期或晚期发作的GDM的能力.
主要方法:
- 一个以人口为基础的队列1394芬兰妇女 (早期诊断糖尿病在怀孕研究) 的HbA1c测量在怀孕8-14周.
- 口服葡萄糖耐受性测试 (OGTTs) 在12-16周进行,如果第一个正常,则在24-28周再次进行.
- 记录了GDM诊断和治疗状态 (甲福林或胰岛素).
主要成果:
- 怀孕早期HbA1c≥35 mmol/mol (5.4%) 是第一次OGTT中高血葡萄糖的最佳预测指标,尽管诊断准确性低 (AUC 0.65).
- 这一HbA1c值在第一个OGTT期间与血葡萄糖水平呈正相关.
- HbA1c ≥35 mmol/mol预测药理治疗的GDM (早期或晚期发病) 的准确性更好 (AUC 0.75).
结论:
- 怀孕早期的HbA1c ≥35 mmol/mol与葡萄糖水平升高有关,并预测药理治疗的GDM.
- 这表明,HbA1c可能有助于识别高风险的妇女在怀孕的第一季度严重的GDM亚型.
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