Predictive value of glycolipid metabolism indicators and coagulation function indicators in early pregnancy for gestational diabetes mellitus
Objective To explore the predictive value of glycolipid metabolism indicators and coagulation function indicators in early pregnancy for gestational diabetes mellitus (GDM). Methods 126 pregnant women who underwent prenatal check ups were selected as the research subjects,and their baseline data and laboratory indicators were collected during the registration at 10-13 weeks' gestation,and they were categorized into the GDM group (n=31) and the non-GDM group (n=95) on the basis of the results of the Oral Glucose Tolerance Test (OGTT) at 24-28 weeks' gestation. The influencing factors of GDM were determined by univariate and multivariate Logistic regression analysis. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of single and combined detection of glycolipid metabolism indicators and coagulation function indicators for GDM. Results In GDM group,the maternal age was (31.01±8.13) years,the pre-pregnancy body mass index (BMI) was (22.13±3.91) kg/m2,the gestational weight gain was (6.58±1.39) kg,the fasting plasma glucose (FPG) was (5.01±0.46) mmol/L,the total cholesterol (TC) was (5.33±1.11) mmol/L,the low-density lipoprotein cholesterol (LDL-C) was (3.96±1.28) mmol/L,the small dense low-density lipoprotein (sdLDL) was (418.33±16.47) mg/dl,the apolipoprotein B (ApoB) was (0.94±0.07) g/L,the apolipoprotein E (ApoE) was (44.35±1.04) mg/L,the glycosylated hemoglobin (HbA1c) was (8.83±0.52)％,and the D-dimer (D-D) was (0.53±0.04) mg/L,which were higher than (27.05±6.03) years,(20.76±3.02) kg/m2,(5.02±1.28) kg,(4.71±0.31) mmol/L,(4.92±0.79) mmol/L,(3.11±0.96) mmol/L,(341.25±14.08) mg/dl,(0.86±0.05) g/L,(40.05±1.52) mg/L,(5.54±0.63)％,and (0.49±0.03) mg/L in non-GDM group;the prothrombin time (PT) was (11.53±0.25) s,the international normalized ratio (INR) was (0.97±0.05),the activated partial thromboplastin time (APTT) was (26.89±1.74) s,and the prothrombin time (TT) was (15.42±0.17) s,which were lower than (11.97±0.29) s,(1.02±0.07),(28.11±1.83) s,and (15.88±0.19) s in non-GDM group (P<0.05). There was no difference in comparison of gestational week of registration,gestational week of OGTT test,number of deliveries,systolic blood pressure (SBP),diastolic blood pressure (DBP),family history of diabetes mellitus,history of smoking,history of alcohol consumption,triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A1 (ApoA1),lipoprotein (a)[LP(a)],fibrinogen (FIB),fibrin degradation products (FDP) between the two groups (P>0.05). Logistic regression analysis was implemented with the occurrence of GDM in pregnant women as the dependent variable,and the 15 factors with P<0.05 in the univariate analysis as the independent variables,and the results showed that high pre-pregnancy BMI,FPG,TC,LDL-C,sdLDL,ApoE,HbA1c,and D-D were the independent risk factors for the occurrence of GDM in pregnant women,and high INR and TT were the protective factors (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of combined detection in predicting the occurrence of GDM in pregnant women was 0.911,the sensitivity was 88.94％,and the specificity was 80.57％,which were higher than those of glycolipid metabolism indicators (0.858,85.35％,74.32％) and coagulation function indicators (0.742,78.59％,64.53％) alone. Conclusion High pre-pregnancy BMI,FPG,TC,LDL-C,sdLDL,ApoE,HbA1c,D-D are independent risk factors for the occurrence of GDM in pregnant women,and high INR,TT are protective factors for the occurrence of GDM in pregnant women;among them,coagulation,blood glucose,and lipids can be used as predictive factors for the occurrence of GDM in pregnant women,and the predictive value of combined detection is more ideal.
Early pregnancyGlycolipid metabolism indicatorsCoagulation function indicatorsGestational diabetesReceiver operating characteristic curve
万方数据
维普
