CAJ | 학술논문

目的：探讨糖化白蛋白（ GA）与脂联素（ ADP）在妊娠糖尿病（ GDM）筛查中的临床应用价值。方法选取2012年04月至2014年02月浙江省瑞安市人民医院妇产科具备完整孕前检查资料，并在浙江省瑞安市人民医院分娩的临床确诊妊娠糖尿病患者196例为研究对象（ GDM组），同期135例健康孕妇为对照组，比较两组GA及ADP检测情况，并利用受试者工作曲线（ ROC曲线）对GA及ADP对GDM的诊断进行评价。结果 GDM组口服葡萄糖耐量试验（ OGTT）时的空腹血糖（ FPG）、餐后1h血糖、餐后2h血糖及GA均高于对照组，GDM组ADP水平低于对照组，差异均具有统计学意义（ t值分别为17．78、15．95、20．01、19．82和18．46，均P＜0．05）。 ROC曲线分析：GA诊断妊娠糖尿病的ROC曲线下面积（AUC）为0．837，诊断意义具有显著性（95％CI：0．723～0．936，P＜0．01），GA相对于妊娠糖尿病的诊断切点为17．3％；ADP诊断妊娠糖尿病的ROC曲线下面积（AUC）为0．736，诊断意义具有显著性（95％CI：0．707～0．819，P＜0．05），ADP相对于妊娠糖尿病的诊断切点为6．4mg/L。结论GA与ADP作为妊娠糖尿病的筛查指标简单、快速具有较好的诊断价值，值得临床推广应用。
목적：탐토당화백단백（ GA）여지련소（ ADP）재임신당뇨병（ GDM）사사중적림상응용개치。방법선취2012년04월지2014년02월절강성서안시인민의원부산과구비완정잉전검사자료，병재절강성서안시인민의원분면적림상학진임신당뇨병환자196례위연구대상（ GDM조），동기135례건강잉부위대조조，비교량조GA급ADP검측정황，병이용수시자공작곡선（ ROC곡선）대GA급ADP대GDM적진단진행평개。결과 GDM조구복포도당내량시험（ OGTT）시적공복혈당（ FPG）、찬후1h혈당、찬후2h혈당급GA균고우대조조，GDM조ADP수평저우대조조，차이균구유통계학의의（ t치분별위17．78、15．95、20．01、19．82화18．46，균P＜0．05）。 ROC곡선분석：GA진단임신당뇨병적ROC곡선하면적（AUC）위0．837，진단의의구유현저성（95％CI：0．723～0．936，P＜0．01），GA상대우임신당뇨병적진단절점위17．3％；ADP진단임신당뇨병적ROC곡선하면적（AUC）위0．736，진단의의구유현저성（95％CI：0．707～0．819，P＜0．05），ADP상대우임신당뇨병적진단절점위6．4mg/L。결론GA여ADP작위임신당뇨병적사사지표간단、쾌속구유교호적진단개치，치득림상추엄응용。
Objective To investigate the clinical value of glycated albumin ( GA ) and adiponectin ( ADP ) in screening gestational diabetes mellitus (GDM).Methods Totally 196 patients diagnosed with GDM and delivering in People ’s Hospital of Ruian City during the period of April 2012 to February 2014 were selected in study group ( GDM group) .At the same period 135 healthy pregnant women were selected in control group .GA and ADP detection were compared between two groups , and the subject working curve ( ROC curve ) was used to evaluate the diagnosis of GDM with GA and ADP .Results FPG, 1hPBG, 2hPBG and GA of GDM group were significantly higher than those of the control group (t value was 17.78, 15.95, 20.01 and 19.82, respectively, all P <0.05), but ADP level was significantly lower (t =18.46, P<0.05).ROC curve analysis indicated that area under the ROC curve (AUC) in diagnosis of GDM by GA was 0.837, and the diagnosis was significant (95%CI: 0.723-0.936,P<0.01).The diagnosis cutoff point of GA to GDM was 17.3%.The area under the ROC curve (AUC) in diagnosis of GDM by ADP was 0.736, and the diagnosis was significant (95%CI:0.707-0.819, P<0.05).The diagnosis cutoff point of ADP to GDM was 6.4mg/L.Conclusion As simple and rapid screening indexes of GDM, GA and ADP have good diagnostic value , and they are worthy of clinical application .