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DIABETES CARE：空腹血糖筛查妊娠糖尿病添新证

2013-04-02 高廉编译 医学论坛网

妊娠糖尿病空腹血糖
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  　　一项新的研究显示，对于资源匮乏地区患者，妊娠24周-28周的空腹血糖（FPG）水平可用于筛查妊娠糖尿病（GDM）。研究由我国北京大学第一医院杨慧霞等人进行，2013年3月27日在线发表于《糖尿病护理》杂志。 　　为评估妊娠期24-28周FPG筛查GDM的实用性，研究者收集我国15家医院24854名既往无GDM孕妇的医疗记录，监测其餐后2小时75g口服葡萄糖耐量（OGTT）结果

空腹血糖筛查妊娠糖尿病
 

　　一项新的研究显示，对于资源匮乏地区患者，妊娠24周-28周的空腹血糖（FPG）水平可用于筛查妊娠糖尿病（GDM）。研究由我国北京大学第一医院杨慧霞等人进行，2013年3月27日在线发表于《糖尿病护理》杂志。

　　为评估妊娠期24-28周FPG筛查GDM的实用性，研究者收集我国15家医院24854名既往无GDM孕妇的医疗记录，监测其餐后2小时75g口服葡萄糖耐量（OGTT）结果。

　　结果显示，FPG切点值定为5.1mmol/L，诊断为GDM的患者达3149例（12.1%）；切点定为4.4 mmol/L则可排除15369例GDM（38.2%）。按此标准（4.4 mmol/L）12.2%的患有轻度GDM的患者漏疹。阳性预测值0.322，阴性预测值0.928。

　　研究者指出，对于空腹血糖水平≥4.4 和≤5.0 mmol/L的患者，需进行OGTT诊断GDM。在中国以FPG筛查GDM，可以使约半数孕妇（50.3%）避免进行75g口服葡萄糖耐性试验。 


Fasting Plasma Glucose at 24–28 Weeks to Screen for Gestational Diabetes Mellitus

OBJECTIVE 
To evaluate the usefulness of a fasting plasma glucose (FPG) at 24–28 weeks’ gestation to screen for gestational diabetes mellitus (GDM).
RESEARCH DESIGN AND METHODS 
The medical records and results of a 75-g 2-h oral glucose tolerance test (OGTT) of 24,854 pregnant women without known pre-GDM attending prenatal clinics in 15 hospitals in China were examined.
RESULTS 
FPG cutoff value of 5.1 mmol/L identified 3,149 (12.1%) pregnant women with GDM. FPG cutoff value of 4.4 mmol/L ruled out GDM in 15,369 (38.2%) women. With use of this cutoff point, 12.2% of patients with mild GDM will be missed. The positive predictive value is 0.322, and the negative predictive value is 0.928.
CONCLUSIONS 
FPG at 24–28 weeks’ gestation could be used as a screening test to identify GDM patients in low-resource regions. Women with an FPG between ≥4.4 and ≤5.0 mmol/L would require a 75-g OGTT to diagnose GDM. This would help to avoid approximately one-half (50.3%) of the formal 75-g OGTTs in China.

    

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    2013-07-07 ms9608593228839890

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    2013-08-11 木头人513

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    2013-09-25 ms5439512287675881

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    2013-04-04 手留余香

    #空腹血糖#

    0

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