Correlation Analysis Of Gestational Diabetes Mellitus With Serum ALT,GGT And BMI Of Pregnant Women

Objective:To explore the relationship between alanine aminotransferase(ALT),glutamyl transpeptidase(GGT),body mass index(BMI)and gestational diabetes mellitus,and to provide reference for clinical prediction of gestational diabetes mellitus.Methods:249 pregnant women who gave birth in this hospital from January 2016 to October 2019 were selected.Including 96 normal pregnant women as control group(group Ⅰ),153 patients with Gestational diabetes mellitus as experimental group,87 patients in diet control group(group Ⅱ)and 66 patients in insulin control group(groupⅢ).The liver function indexes,height and weight of all pregnant women were recorded in the early pregnancy test,and the body mass index(BMI)was calculated.The liver f unction indexes included aspartate aminotransferase(AST),alanine aminotransferase(ALT),y-glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),etc.All pregnant women were recorded for their post-admission related factors and postpar turn neonatal weight,including gestational age and age at delivery.The correlation of BMI,liver function indexes ALT and GGT in the early pregnancy with gestational diabetes mellitus was analyzed.Results:(1)The age of pregnant women and the weight of newborn in insulin control group(group Ⅲ)were higher than those in control group(group Ⅰ)and diet control group(group Ⅱ),with statistically significant difference(P<0.01).The gestational ages of diet control group(group Ⅱ)and insulin control group(group Ⅲ)were lower than those of control group(group Ⅰ),and the gestational ages of insulin control group(group Ⅲ)were lower than those of diet control group(group Ⅱ),with statistically significant differences(all P<0.01).(2)Correlation analysis was carried out among the clinical data of each group.The gestational age,weight and BMI in the early pregnancy of the three groups of pregnant women before delivery were positively correlated with the weight of the newborn.(3)BMI of diet control group(group Ⅱ)and insulin control group(group Ⅲ)were both higher than that of control group(group Ⅰ),the difference was statistically significant(P<0.05).The area under ROC curve for BMI diagnosis is 0.700,the sensitivity is 67.32%,the specificity is 37.71%,and the cutoff value is 27.2.27.2Kg/m2 was taken as the critical value for diagnosis of GDM.(4)ALT in insulin control group(group Ⅲ)was higher than that in control group(group Ⅰ),and the difference was statistically significant(P<0.05).The area under ROC curve for ALT diagnosis is 0.577,the sensitivity is 60.13%,the specificity is 55.21%,and the cutoff value is 8.This indicates that ALT has Diagnostic significance for GDM,with 8U/L as the diagnostic threshold.(5)Liver function indexes such as GGT,AST,ALP in diet control group(group Ⅱ)and insulin control group(groupⅢ)were not statistically significant compared with control group(group Ⅰ)(all P>0.05).Conclusion:(1)BMI and ALT can be used as clinical reference indexes to predict GDM.(2)GGT,AST,ALP and other liver function indexes have no obvious clinical reference value for the prediction of GDM in this study.