Fasting Plasma Glucose And Serum Uric Acid In The First Trimester As Predictors Of Gestational Diabetes Mellitus During The Second Pregnancy

Objective To investigate the value of fasting plasma glucose(FPG)and serum uric acid(SUA)in screening gestational diabetes mellitus(GDM).Methods The clinical data of 137 pregnant women who gave birth twice in First Affiliated Hospital of Guangxi Medical University from December 2012 to January 2017 were analyzed retrospectively.The study was divided into two groups:58 cases of normal glucose tolerance(NGT)in first fetus and 79 cases of gestational diabetes mellitus(GDM)in the first fetus.Two cases of the second child of their FPG and SUA in the two groups were compared.The two-classification logistics regression analysis was used to identify the risk factors of GDM.A receiver operating characteristic(ROC)curve was plotted to evaluate predictive value and identify optimal cut-off points of FPG and SUA for variables that were significantly associated with GDM in the logistic regression analysis.Results When the first child was GDM or NGT,there was no significant difference in age,delivery mode,fasting blood-glucose,serum uric acid,etc.When the firs child was GDM,analysis of GDM and NGT in the second fetus,The FPG and SUA were significantly higher than the NGT group(P<0.05).The FPG and SUA were the independent risk factors for GDM.The combination of FPG and SUA has a efficiency high in the prediction for GDM,and the best cut-off predictive value for GDM were 4.51mmol/L for FPG or 210.5 ?mol/L for SUA using Youden index in the ROC analysis.When the firs child was NGT,analysis of GDM and NGT in the second fetus,The age and FPG were significantly higher than the NGT group(P<0.05).The age and FPG were the independent risk factors for GDM.The combination of age and FPG has a efficiency high in the prediction for GDM and the best cut-off predictive value for GDM were 35.5 years old for age or 4.63mmol/L for FPG using Youden index in the ROC analysis.Conclusion Whether the first child was GDM or NGT,The levels of FPG were significantly higher than those in GDM pregnant women.When the first fetus was GDM,FPG?4.51mmol/L or SUA?210.5?mol/L we should be alert to GDM when the second fetus is pregnant;When the first fetus is NGT,FPG?4.63mmol/L or the age?35.5 years old we should be also alert to GDM.So we can choose the best time to prepare pregnancy and improve pregnancy outcomes.