孕13周+6前TyG指数、Hcy、PLGF、HbA1c水平检测对妊娠期糖尿病的预测价值研究OA
Predictive Value of TyG Index,Hcy,PLGF and HbA1c Levels Before 13+6 Weeks of Pregnancy on Gestational Diabetes Mellitus
目的 探讨孕13周+6前三酰甘油葡萄糖(TyG)指数、同型半胱氨酸(Hcy)、胎盘生长因子(PLGF)、糖化血红蛋白(HbA1c)水平对妊娠期糖尿病(GDM)的预测价值.方法 选取2024年1月至2025年1月于秦皇岛市第一医院定期产检的孕妇151例,根据75 g口服葡萄糖耐量试验(孕24～28周)结果分为GDM组(37例)和糖耐量正常(NGT)组(114例).比较两组75 g口服葡萄糖耐量试验结果、一般临床资料;采用多因素Logistic回归分析孕妇发生GDM的影响因素;采用ROC曲线评估孕13周+6前TyG指数、Hcy、PLGF、HbA1c水平对GDM的预测价值.结果 GDM组服糖前0 h血糖、服糖后1 h血糖、服糖后2 h血糖水平显著高于NGT组(P<0.001).GDM组糖尿病家族史、TyG指数、Hcy、HbA1c水平高于NGT组,PLGF水平低于NGT组(P<0.05).多因素Logistic回归分析结果显示,PLGF为孕妇发生GDM的独立保护因素(OR=0.715,95%CI:0.574～0.891,P=0.003),TyG指数、Hcy、HbA1c为孕妇发生GDM的独立危险因素(OR=1.763,95%CI:1.286～2.417,P<0.001;OR=1.523,95%CI:1.204～1.927,P<0.001;OR=1.994,95%CI:1.358～2.928,P<0.001).ROC曲线评估显示,孕13周+6前TyG指数、Hcy、PLGF、HbA1c单独检测预测GDM的曲线下面积分别为0.795、0.753、0.735、0.740,四者联合检测预测GDM的曲线下面积为0.890,四者联合预测优于单独预测(P<0.05).结论 孕13周+6前高水平TyG指数、Hcy、HbA1c及低水平PLGF孕妇更易发生GDM,上述指标联合检测具有较高预测价值.
Objective To analyze the predictive value of triglyceride-glucose(TyG)index,homocysteine(Hcy),placental growth factor(PLGF),and glycated hemoglobin(HbA1c)levels measured before 13+6 weeks of gestation for gestational diabetes mellitus(GDM).Methods A total of 151 pregnant women who underwent regular prenatal examinations in the First Hospital of Qinhuangdao from January 2024 to January 2025 were enrolled.According to the results of the 75 g oral glucose tolerance test(OGTT)performed at 24-28 weeks of gestation,they were divided into the GDM group(n=37)and the normal glucose tolerance(NGT)group(n=114).The OGTT results and general clinical data were compared between the two groups.Multivariate Logistic regression analysis was used to explore the influencing factors of GDM in pregnant women.Receiver operating characteristic(ROC)curves were applied to analyze the predictive value of TyG index,Hcy,PLGF,and HbA1c levels measured before 13+6 weeks of gestation for GDM.Results Fasting plasma glucose at 0 h,1 h post-load glucose,and 2 h post-load glucose in the GDM group were significantly higher than those in the NGT group(P<0.001).The proportion of family history of diabetes and levels of TyG index,Hcy,and HbA1c in the GDM group were significantly higher than those in the NGT group,while the level of PLGF was significantly lower in the GDM group than those in the NGT group(P<0.05).Multivariate Logistic regression analysis showed that PLGF was an independent protective factor for GDM in pregnant women(OR=0.715,95%CI:0.574-0.891,P=0.003),whereas TyG index,Hcy,and HbA1c were independent risk factors for GDM(OR=1.763,95%CI:1.286-2.417,P<0.001;OR=1.523,95%CI:1.204-1.927,P<0.001;OR=1.994,95%CI:1.358-2.928,P<0.001).ROC curve analysis demonstrated that the areas under the curve(AUC)of TyG index,Hcy,PLGF,and HbA1c measured before 13+6 weeks of gestation for predicting GDM alone were 0.795,0.753,0.735,and 0.740,respectively.The AUC of the combined detection of the four indicators for predicting GDM was 0.890,and the combined prediction was superior to single prediction(P<0.05).Conclusion Pregnant women with high levels of TyG index,Hcy and HbA1c and low level of PLGF before 13+6 weeks of gestation are more likely to develop GDM,and the combined detection of the above indicators has high predictive value.
路春梅;裴梦然;赵云刚;齐俊巧;杨旭;魏敬艳;侯雪晶
秦皇岛市第一医院产科,河北 秦皇岛 066000秦皇岛市第一医院产科,河北 秦皇岛 066000秦皇岛市海港医院普外科,河北 秦皇岛 066000秦皇岛市第一医院产科,河北 秦皇岛 066000秦皇岛市第一医院产科,河北 秦皇岛 066000秦皇岛市第一医院产科,河北 秦皇岛 066000秦皇岛市第一医院产科,河北 秦皇岛 066000
妊娠期糖尿病孕早期三酰甘油葡萄糖指数同型半胱氨酸胎盘生长因子糖化血红蛋白
gestational diabetes mellitusearly pregnancytriglyceride-glucose indexhomocysteineplacental growth factorglycated hemoglobin
《转化医学杂志》 2026 (6)
934-939,6
河北省2019年度医学科学研究计划项目(20191388)
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