Predictive Value Of Blood Lipid And Fasting Blood Sugar In Early Pregnancy For Gestational Diabetes Mellitus

ObjectiveTo explore the predictive value of serum lipid level and fasting blood glucose(FPG)level in early pregnancy(10-12 weeks)for gestational diabetes mellitus(GDM),in order to provide new indicators and methods for the early diagnosis and treatment of GDM patients.Methods:From December 2015 to June 2016,650 singleton pregnant woman who visited the obstetrics department of Qingdao Univerisity Medicail Group Gaomi Hospital were selected as the research objects.Fasting venous blood of all pregnant women in the early pregnancy(10-12 weeks)was collected to detect serum lipid,Apolipoprotein-C and fasting blood glucose.Age,parity and gestational weeks were recorded.Height and weight were measured,and body mass index was calculated and recorded.GDM was diagnosed by OGTT at 24-28 weeks of gestation.The pregnant women were followed up until delivery.The gestational weeks and birth weight of the newborn were counted and recorded.The OGTT results of 650 pregnant women at 24-28 weeks of gestation showed that 87 pregnant women with GDM,563 pregnant women with normal glucose tolerance,excluding malformations,premature birth and lost interviewees(2 cases of severe cardiac malformations,1 case of hydrocephalus,7 cases of premature birth and 11 cases of lost interviews).Finally 629 pregnant women were enrolled.Among them,76 GDM pregnant women were classified as GDM group.553 pregnant women with normal OGTT were matched 1:2 according to age,number of deliveries and body mass index,and 152 cases of control group were obtained.Serum total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),lipoprotein-a(Lp(a)),Apolipoprotein-C?(Apo-C?)and fasting blood glucose(FPG)were measured by a full-system biochemical analyzer.The predictive value of serum lipid(TC,TG,HDL,LDL,Lp(a)),Apolipoprotein-C?(Apo-C?)and fasting blood glucose(FPG)levels in early pregnancy for gestational diabetes mellitus(GDM)was analyzed.SPSS-18 software was used to analyze the data,P < 0.05 showed that there was significant difference.The measurement data of normal distribution were expressed by x?±s,the difference between groups was tested by t test,and P < 0.05 showed that there was significant difference.Multivariate logistic regression was used to analyze high-risk factors,and ROC curve wasdrawn to calculate the predictive value.Result1.The gestational age were significantly lower than those in the control group,statistical analysis showed significant difference(P < 0.01);birth weight and OGTT blood glucose(fasting,1 hour,2 hours)of pregnant women in GDM group were significantly higher than those in the control group,there were significant differences in statistical analysis(P<0.05,0.01).2.The levels of triglyceride(TG),low density lipoprotein(LDL),LDL/HDL and fasting blood glucose(FPG)in GDM group were significantly higher than those in control group,statistical analysis showed significant difference(P < 0.05,0.01);the levels of serum total cholesterol(TC),high density lipoprotein(HDL),lipoprotein-a(Lp(a))and apolipoprotein-C?(Apo-C?)were compared between the two groups,and there was no significant difference between the two groups(P > 0.05).3.Multivariate regression analysis showed that TG and FPG were independent risk factors for GDM(OR was 3.98 and 2.41,respectively,P < 0.001);multivariate regression analysis showed that TC,HDL,LDL,LDL/HDL,Lp(a)and Apo-C? were not independent risk factors for GDM,and there was no significant difference in statistical analysis(P > 0.05).4.The ROC curve showed that the largest areas under the curve of were 0.64 and0.71,respectively with TG?1.78mmol/L,FPG?4.97mmmol/L as cutoff value.The sensitivity of GDM was predicted to be 60.7 % and 52.8 % respectively with TG?1.78mmol/L,FPG?4.97mmmol/L as cutoff value,the specificity was 73.8% and60.7% respectively,and the sensitivity and specificity of the combination of the two were73.2% and 76.7% respectively.Conclusion1.TG and FPG in early pregnancy were independent risk factors for GDM.2.Both TG and FPG in early pregnancy can be used as early predictors of GDM,and their combined prediction can improve the predictive value.