标题：孕早期空腹血糖联合糖化血红蛋白检测在妊娠期糖尿病筛查中的应用价值

      作者：朱翠丽，胡蓉，林丽萍，钱英    上海松江中心医院产科，上海 201600

      卷次： 2020年31卷18期

      【摘要】 目的 探讨孕早期联合检测空腹血糖(FPG)和糖化血红蛋白(HbAlc)在妊娠期糖尿病(GDM)发生风险中的预测作用。方法 收集2019年1~12月期间于孕8~13周开始在上海松江中心医院产科门诊建卡并定期产检的孕妇资料，选取孕24~28周确诊GDM的214例孕妇作为观察组，同时随机选取同期产检血糖正常的210例孕妇作为对照组。比较两组孕妇孕早期空腹血糖和糖化血红蛋白的差异，并建立ROC曲线，分析孕早期空腹血糖和糖化血红蛋白预测GDM的价值。结果 两组孕妇的年龄、孕产次、BMI及建卡孕周的一般资料比较差异均无统计学意义(P>0.05)；观察组与对照组孕妇测定的孕早期FPG水平[(4.30±0.41) mmol/L vs (3.94±0.39) mmol/L]和HbAlc水平[(4.91±0.40)% vs (4.74±0.36)%]比较，观察组明显高于对照组，差异均具有统计学意义(P<0.05)；建立ROC曲线得到孕早期FPG和HbAlc预测GDM的曲线下面积(AUC)分别为 0.737、0.619，而两组联合检测预测GDM的AUC为0.766，诊断效能高于单独指标对GDM的预测作用。结论 孕早期FPG和HbAlc联合检测对GDM发生的预测有一定的价值。
      【关键词】 孕早期；空腹血糖；糖化血红蛋白；妊娠期糖尿病；受试者工作曲线
      【中图分类号】 R714.256 【文献标识码】 A 【文章编号】 1003—6350（2020）18—2360—03

Predictive role of fasting blood glucose and glycosylated hemoglobin in the risk of gestational diabetes mellitus inearly pregnancy.
ZHU Cui-li, HU Rong, LIN Li-ping, QIAN Ying. Department of Obstetrics, Shanghai Songjiang CentralHospital, Shanghai 201600, CHINA
【Abstract】 Objective To investigate the predictive role of fasting blood glucose (FPG) and glycosylated hemo-globin (HbA1c) in the risk of gestational diabetes mellitus (GDM) in early pregnancy. Methods Data were collectedfrom pregnant women who started to establish a card in Outpatient Department of Obstetrics, Shanghai Songjiang Cen-tral Hospital had regular prenatal examinations at 8 to 13 weeks from January 2019 to December 2019. A total of 214pregnant women diagnosed with GDM at 24 to 28 weeks gestation were selected as the observation group, and 210 preg-nant women with normal blood glucose during the same period were randomly selected as the control group. The differ-ence of FBG and HbAlc between the two groups of pregnant women in early pregnancy was compared, and the ROCcurve was established to analyze the value of FBG and HbAlc in predicting GDM in early pregnancy. Results Therewas no statistically significant differences in the general data of the two groups of pregnant women in terms of age, pari-ty, BMI and gestational age (all P>0.05). In the early pregnancy, the FPG level and HbAlc level in the observation groupwere (4.30±0.41) mmol/L and (4.91±0.40)%, respectively, which were significantly higher than corresponding (3.94±0.39) mmol/L and (4.74±0.36)% in the control group (all P<0.05). According to the ROC curve, the AUC predicted byFPG and HbAlc for GDM in early pregnancy was 0.737 and 0.619, respectively, while the AUC predicted by the com-bined detection for GDM in the two groups was 0.766, indicating that the diagnostic efficiency was higher than that pre-dicted by the single indicator for GDM. Conclusion The combined detection of FPG and HbAlc in early pregnancyhas certain value in predicting the occurrence of GDM.
      【Key words】 Early pregnancy; Fasting plasma glucose (FPG); Glycosylated hemoglobin (HbA1c); Gestationaldiabetes mellitus (GDM); Receiver operating characteristic curve (ROC)