| Purpose:Study on the relationship between gestational diabetes mellitus(GDM)and fasting plasma glucose(FPG),triglyceride(TG)and serum ferritin(SF),which are measured in normal pregnant women in the early pregnancy,so as to provide new ideas for early detection and prevention of GDM.Method:From January 2016 to June 2016,pregnant women who had routine prenatal examinations at the obstetrics clinics in the Eastern District of Suzhou Municipal Hospital were selected.Also,this study requires singleton pregnancy with natural pregnancy that has no previous physical fitness,no gestational anemia,and no medication history.FPG,TG and SF were measured at 11 to 13 weeks of pregnancy,and oral glucose tolerance test was performed at 75gr at 24 to 28 weeks.According to the results of oral glucose tolerance test,pregnant women were divided into GDM group and normal control group.Then,the levels of FPG,TG and SF in the early pregnancy of the two groups were compared.Multivariate logistic regression analysis was used to determine the independent risk factors for GDM.At the same time,logistic regression model was established to draw the Receiver operating characteristic(ROC)curve of model.Subsequently,the area under the curve was recorded to analyze the clinical value of FPG,TG and SF in predicting the occurrence of GDM in early pregnancy.Predictive models were established based on maternal age,body mass index(BMI),FPG,TG and SF,so that analyze the clinical value of the model in the occurrence of GDM.Result:1,The statistical difference of risk factors of GDM was based on 5%significant level:FPG(P<0.05),TG(P<0.05),SF(P<0.05)in the early pregnancy had significant difference.2,After correction of confounding factors,multivariate logistic regression analysis showed that age(OR=1.088,P=0.005),BMI(OR=1.063,P=0.012),FPG(OR=1.09,P=0.00),TG(OR=1.65,P=0.00),SF(OR=1.009,P=0.00)were all significant risk factors for GDM,and they were also significant promoting factors.3,The best cut-off values of FPG,TG and SF for predicting GDM in early pregnancy were 5.01 mmol/L,1.46 mmol/L and 62.02 ng/ml,respectively.The predicting GDM by FPG in early pregnancy:the AUC was 0.642,the sensitivity was 61.54%,and the specificity was 59.77%.The TG in early pregnancy:the AUC was 0.588,the sensitivity was 69.05%and the specificity was 45.52%.The SF of early pregnancy:AUC was 0.857,the sensitivity was 73.37%and the specificity was 86.04%.In contrast,SF has high diagnostic value in early pregnancy.4,Regression equation model is that:log[P/(1-P)]=-17.648+0.092*Age+0.065*BMI+1.103*FPG+0.342*TG+0.089*SF.After logistic transformation,it can be used to estimate the probability of GDM occurrence,thatis,PGDM=1/{1+exp[-(-17.648+0.092*Age+0.065*BMI+1.103*FPG+0.342*TG+0.089*SF)]}.Using this model to predict the GDM risk,the AUC is 0.896;95%Cl is 0.877 to 0.912,P<0.01;the threshold value is 0.13,the sensitivity is 81.99%,and the specificity is 82.77%.Conclusion:The FPG,TG,SF and GDM in early pregnancy are correlated to some extent.Pregnant women with elevated FPG,TG and SF should be vigilant against the occurrence of GDM.Combining laboratory indicators(including FPG,TG,SF)and clinical indicators(including Age and BMI)in early pregnancy can better predict the risk of GDM. |
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