血糖控制不佳的妊娠期糖尿病(GDM)与不良的妊娠结局有关。然而,GDM血糖控制的适当标志物尚未得到充分评估.
我们回顾性研究了77例GDM患者及其婴儿。平均糖化白蛋白(GA),糖化血红蛋白(HbA1c),根据有无婴儿并发症(并发症或非并发症)对两组GDM患者的GA/HbA1c和GA/HbA1c进行了分层.我们评估了GA中婴儿并发症的可预测性,HbA1c,通过受试者工作特征分析(ROC)和GDM女性的GA/HbA1c。
在并发症和非并发症方面,GA和GA/HbA1c与新生儿低血糖显著相关(13.9%vs.13.0%,p<0.001和2.49vs.2.33,p<0.001),呼吸系统疾病(13.7%vs.13.2%,p=0.013和2.48vs.2.34,p<0.001),心肌肥厚(14.5%vs.13.0%,p<0.001和2.59vs.2.33,p<0.001),和大的胎龄(14.5%vs.13.1%,p<0.001和2.58vs.2.34,p<0.001)。与ROC中每个婴儿并发症相比,GA和GA/HbA1c的曲线下面积高于HbA1c。尤其是,GA和GA/HbA1c在预测心肌肥厚和大胎龄时具有最高的AUC(GA;0.92和0.92,GA/HbA1c;分别为0.91和0.86)。尽管GA和GA/HbA1c与婴儿并发症的数量之间存在统计学上的显着正相关(GA:r=0.417,p<0.001;GA/HbA1c:r=0.408,p<0.001),它们的相关性很弱。
与HbA1c相比,妊娠晚期GDM的GA和GA/HbA1c可能有助于预测GDM引起的婴儿并发症。
Gestational diabetes mellitus (GDM) with poorly controlled glycemia is associated with poor pregnancy outcomes. However, adequate markers for glycemic control in GDM have not been fully evaluated.
We retrospectively studied 77 patients with GDM and their infants. Mean glycated albumin (GA), glycated hemoglobin (HbA1c), and GA/HbA1c in GDM were compared between two groups stratified by the presence or absence of infant complications (complications or non-complications). We assessed the predictability of infant complications in GA, HbA1c, and GA/HbA1c of women with GDM by receiver operating characteristic analysis (ROC).
In complications and non-complications, GA and GA/HbA1c were significantly associated with neonatal hypoglycemia (13.9% vs. 13.0%, p < 0.001 and 2.49 vs. 2.33, p < 0.001, respectively), respiratory disorders (13.7% vs. 13.2%, p = 0.013 and 2.48 vs. 2.34, p < 0.001, respectively), myocardial hypertrophy (14.5% vs. 13.0%, p < 0.001 and 2.59 vs. 2.33, p < 0.001, respectively), and large for gestational age (14.5% vs. 13.1%, p < 0.001 and 2.58 vs. 2.34, p < 0.001, respectively). Compared with each infant complication in ROC, GA and GA/HbA1c had higher area under the curve than HbA1c. Especially, GA and GA/HbA1c had highest AUC in predicting myocardial hypertrophy and large for gestational age (GA; 0.92 and 0.92, GA/HbA1c; 0.91 and 0.86, respectively). Although statistically significant positive correlations were found between GA and GA/HbA1c and the number of infant complications (GA: r = 0.417, p < 0.001; GA/HbA1c: r = 0.408, p < 0.001), their correlations were weak.
Compared with HbA1c, GA and GA/HbA1c of GDM in late pregnancy might be useful for predicting infant complications arising from GDM.