The Value Of Blood Biochemical Predictor Of Gestational Diabetes Mellitus During The Middle Pregnancy

1 Background and ObjectivesGestational diabetes mellitus(GDM)is a kind of special disease during pregnancy,with normal glucose metabolism before pregnancy,diabetes appear during pregnancy,the harm to the mother and baby is greater,more often natural fade after the end of pregnancy,but significantly increased the risk of type 2 diabetes in the future,its clinical manifestation is not typical,the 75 g oral glucose tolerance test was clearly diagnosed in the 24th to 28th week of pregnancy.Therefore,it is of great significance for pregnant women in GDM to find and actively intervene and to reduce their short-term and long-term harm to pregnant women and their perinatal.This study through analysis and comparison two groups(the normal pregnant group and gestational diabetes mellitus group)indexes include fasting plasma glucose,serum creatinine,absolute value of neutrophils and other biochemical indicators.To discuss the value of fasting plasma glucose,serum creatinine,absolute value of neutrophils and other biochemical indicators single prediction and combined to predict gestational diabetes mellitus.2 Object and MethodsChoose all dates between January 2016 to February 2017 in the second affiliated hospital of zhengzhou university,a total of 977 cases as the research object,they all single pregnancy,at the middle pregrance tests fasting plasma glucose,blood routine,liver function,renal function,at 24th to 28th week test 75 g oral glucose tolerance test.According to the diagnostic criteria and exclusion criteria,728patients was enrolled.According to the results of 75g oral glucose tolerance test,the subjects were divided into gestational diabetes group and normal pregnancy group,138 cases of gestational diabetes group,and 590 normal pregnancy group.General clinical data of the study subjects:name,age,gestational week,past history,etc.;The blood biochemical indicators of fasting blood glucose,liver function,kidney function and blood routine,the results of 75g oral glucose tolerance test were recorded.SPSS 21.0 statistical software was used to analyze the data.t test compared the differences between the two groups of biochemical indexes,and logistic regression established the joint predictors,and the prediction value was evaluated by ROC curve.3 Research Results3.1 General clinical data comparisonThere were no statistically significant difference between gestational diabetes mellitus group and normal pregnancy group of gestational weeks(P>0.05).The age of gestational diabetes group was greater than normal pregnancy group,and the difference was statistically significant(P<0.05).3.2 Comparison of blood biochemical indexesGestational diabetes group compared with normal control group,the pregnancy fasting plasma glucose(FPG),alanine aminotransferase(ALT),alkaline phosphatase(ALP)and gamma pancreatic acyl transferase(GGT),white blood cell count(WBC),neutrophil absolute value(NEU),red blood cell count(RBC)increased,the differences were statistically significant(P<0.05);Neutrophil-lymphocyte ratio(NLR)increased,but the difference was not statistically significant(P>0.05).Creatinine(Cr)decreased,and the difference was statistically significant(P<0.05).During the late pregnancy,the OGTT result of fasting plasma glucose,1 hour of glucose after sugar,and 2 hours of glucose after sugar,all of which were statistically significant(P<0.05).3.3 The diagnosis rate of gestational diabetes mellitus with different fasting plasma glucose levels during pregnancyDuring pregnancy,fasting plasma glucose was divided into 4 groups by0.5mmol/L.With the increase of FPG level,the diagnosis rate of GDM increased gradually,and the total difference between the four groups was statistically significant.(?~2=58.546,P=58.546).3.4 Different fasting plasma glucose levels and OGTT abnormal types of gestational diabetes mellitus were detected during pregnancyIn the three groups,there was no statistically significant difference in the proportion of pure fasting plasma glucose(?~2=3.665,P=0.160),but simple postprandial blood glucose,fasting blood glucose and postprandial blood glucose between three groups was statistically significant(?~2=11.662,P=0.004,?~2=6.070,P=0.048).3.5 The comparison of the diagnosis rate of gestational diabetes mellitus in fasting plasma glucose by percentile method during pregnancyThe incidence of the highest percentage of gestational diabetes mellitus was compared with the incidence of gestational diabetes mellitus in the lowest percentile,OR 4.082(95%CI2.286~7.889).3.6 The value of blood biochemical indicators in pregnancy alone and jointly predicted gestational diabetes mellitus.Pregnancy in fasting plasma glucose(FPG),Alanine aminotransferase(ALT),Alkaline phosphatase(ALP)and Gamma-glutamyl transpeptidase(GGT),white blood cell count(WBC),neutrophil absolute value(NEU),red blood cell count(RBC),creatinine(Cr)separate prediction gestational diabetes mellitus the ROC curve area were 0.665,0.564,0.569,0.557,0.559,0.566,0.583,0.563;Establish joint predictors the ROC curve area was 0.690.4 Conclusion4.1 With the increase of fasting plasma glucose level during pregnancy,the risk of GDM increased gradually.4.2 Fasting plasma glucose of different levels during pregnancy and the OGTT abnormal type of GDM in late pregnancy were different.4.3 A single blood biochemical index predicts GDM the value lower,and joint prediction can improve the value.