怀孕早期血糖和不良结果之间的关系:TOBOGM研究的发现
Arianne Sweeting1, Joanne Enticott2, Jincy Immanuel3
1Department of Endocrinology, Royal Prince Alfred Hospital and University of Sydney, Sydney, New South Wales, Australia.
Diabetes care
|July 31, 2024
概括
怀孕早期口服葡萄糖耐受性测试 (OGTT) 的结果与妊娠糖尿病 (GDM) 的并发症有关. 高高的1小时OGTT葡萄糖水平在高风险怀孕预测主要的围产期问题.
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:
- 妊娠期糖尿病 (GDM) 诊断通常发生在怀孕后期.
- 早期识别高血糖危险因素及其与怀孕结果的关联至关重要.
- 预订妊娠糖尿病患者 (TOBOGM) 队列的治疗提供了评估早期怀孕代谢标志物的数据.
研究的目的:
- 评估怀孕早期口服葡萄糖耐受性测试 (OGTT) 葡萄糖水平与怀孕并发症之间的关联.
- 建立用于识别高风险妊娠的预后OGTT值.
- 为GDM和相关疾病的临床管理策略提供信息.
主要方法:
- 招募具有高血糖危险因素的个体参加国际多中心GDM治疗试验.
- 在不到20周的怀孕期,进行2小时,75克的OGTT.
- 早期OGTT葡萄糖度的分析,连续和分类 (正常,低频段,高频段).
主要成果:
- 在禁食,1小时和2小时的OGTT葡萄糖水平和后来GDM诊断之间发现了持续的积极关联.
- 升高的1小时和2小时葡萄糖水平与复合周产期不良结果的风险增加以及对妊娠年龄大的后代相关.
- 高高的1小时OGTT葡萄糖 (≥10.6 mmol/L) 是唯一一个有意义地预测复合周产期结果的类别.
结论:
- 怀孕早期的OGTT葡萄糖水平显示出与不良妊娠结果的持续积极关联.
- 在高风险妊娠中,高1小时的OGTT葡萄糖水平是主要围产期并发症的重要预测因素.
- 这些发现支持早期OGTT查在怀孕期间风险分层的有用性.
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