糖尿病与妊娠

　　【摘要】目的 探究孕中期血清铁蛋白水平(SF)与妊娠期糖尿病(GDM)的相关性及对GDM的临床意义。 方法 对66例GDM(GDM组)患者和66名正常对照(NC组)孕妇行回顾性分析，分析孕中期(15~20周)SF水平与妊娠中后期(24~28周)餐后血糖及其他一般资料，利用受试者工作特征(ROC)曲线分析孕早中期SF水平对于GDM发生的判断价值。 结果 GDM组孕中期SF水平、孕晚期餐后血糖水平均高于NC组(P均<0.001)。相关分析结果提示，孕晚期餐后血糖水平、孕中期SF水平、孕前期BMI与新生儿出生体重正相关(r=0.388、0.401、0.455，P<0.001)。以SF水平判断孕妇发生GDM的ROC曲线下面积为0.875(95%CI=0.813~0.934)。以孕中期SF=151.87μg/L为界值判断GDM发生时的敏感性、特异性和准确性分别为82.3%,93.9%,90.8%。结论 孕中期SF水平与GDM发生相关。

　　【关键词】血清铁蛋白;糖尿病，妊娠;相关性

　　[Abstract] Objective To investigate the relationship between maternal serum ferritin (SF)level and gestational diabetes mellitus(GDM), and to evaluate the ability of SF in predicting the incidence of GDM. Methods 66 GDM patients (GDM group) and 66 healthy pregnant women( NC group) were studied retrospectively. The clinical characteristics, SF levels during 15~20 gestational weeks and postprandial blood sugar (PPBS) during 24~28 gestational weeks, were analyzed. The value of early second-trimester SF levels in predicting GDM was evaluated by receiver operating characteristic (ROC) curve. Results The mean levels of SF and PPBS were significantly higher in GDM group than in the control group(t1=9.338;t2=13.533，all P<0.001).The correlation analysis revealed that SF levels in GDM group were positively associated with body mass index (BMI), the levels of PPBS and the weight of neonates (r=0.388、0.401、0.455，all P<0.001). ROC curve analysis showed that the area under the SF curve (AUC) was 0.875 (95%CI:0.813~0.934).When the cut-off value of SF was 151.9 μg/L, the sensitivity, specificity and veracity in assessing the incidence of GDM were 82.3%,93.9% and 90.8%, respectively. Conclusion SF level in the early second trimester has the diagnostic value for GDM.

　　【Key words】Serum ferritin; Diabetes, gestational ;Correlation