应用受试者工作曲线评价血清25-羟基维生素D3诊断妊娠期糖尿病的价值

发布时间：2018-02-03 14:43

本文关键词： 妊娠期糖尿病 -羟基维生素D ROC曲线　出处：《东南大学学报(医学版)》2015年06期 　论文类型：期刊论文

【摘要】：目的:应用受试者工作曲线(ROC曲线)评价血清25-羟基维生素D3(25[OH]D3)对妊娠期糖尿病(GDM)的早期诊断价值。方法:回顾分析2014年1月至6月溧阳市妇幼保健院产科产检的妊娠期为16~20周的孕妇,检测空腹血糖(FBG)和血清25[OH]D3质量浓度,于妊娠24~28周进行75 g口服葡萄糖耐量试验(OGTT),并根据此时的空腹血糖(FBG)及OGTT结果诊断为GDM组(n=68)和正常孕妇组(n=100),比较两组间妊娠期血清25[OH]D3质量浓度;两独立样本行t检验,25[OH]D3对GDM发生风险的预测行Logistic回归分析,对诊断价值行受试者工作特性(ROC)曲线分析。结果:GDM组及正常妊娠组的血清25[OH]D3质量浓度随着孕周的增加稍呈下降趋势,两孕周间差异有统计学意义(P0.05);在孕16~20周、孕24~28周,GDM组25[OH]D3质量浓度均显著低于正常妊娠组(P0.01);Logistic回归分析显示,血清25[OH]D3质量浓度与GDM发病相关,是GDM独立危险因素;受试者工作曲线显示,在孕16~20周血清25[OH]D3质量浓度小于16.13 ng·ml-1预测GDM的效果最佳,其灵敏性为73.0%,特异性为66.2%,约登指数为0.39,ROC曲线下面积为0.717(95%CI为0.639~0.794);孕24~28周血清25[OH]D3质量浓度小于14.84 ng·ml-1预测GDM的效果最佳,其灵敏性为67.0%,特异性为77.9%,约登指数为0.45,ROC曲线下面积为0.723(95%CI为0.645~0.801)。结论:GDM孕妇血清25[OH]D3质量浓度明显降低,维生素D缺乏与GDM发病相关;两时间段诊断GDM的效率相当,孕16~20周时血清25[OH]D3质量浓度最佳诊断临界点为16.13 ng·ml~(-1)。
[Abstract]:Objective: to evaluate the serum 25-hydroxyvitamin D _ 3o _ (25) by using the operating curve of subjects (ROC curve). [Methods: from January 2014 to June, the pregnant women in Liyang Maternal and Child Health Hospital who were pregnant women with gestational period of 16 ~ 20 weeks were analyzed retrospectively. The value of D3) in the early diagnosis of gestational diabetes mellitus (GDM) was analyzed retrospectively from January 2014 to June in Liyang Maternal and Child Health Hospital. Detection of fasting blood glucose (FBG) and serum 25. [The concentration of OH] D3 was measured by oral glucose tolerance test (OGTT) at 24 weeks after gestation. According to the results of fasting blood glucose (FBG) and OGTT at this time, it was diagnosed as GDM group (n = 68) and normal pregnant women group (n = 100). The serum 25 of pregnant women was compared between the two groups. [OH] D3 concentration; t-test 25 for two independent samples. [OH] D3 was used to predict the risk of GDM by Logistic regression analysis. The diagnostic value was analyzed by ROCcurve. Results the serum 25 in the GDM group and the normal pregnancy group was 25. [The concentration of OH] D3 decreased slightly with the increase of gestational week, and the difference between the two gestational weeks was statistically significant (P0.05), and at the 20th week of gestation, at the 24th week of gestation, the GDM group was 25. [The results of logistic regression analysis showed that the concentration of OH] D3 was significantly lower than that of normal pregnancy group. [The concentration of OH] D3 was associated with the onset of GDM and was an independent risk factor for GDM. [OH] D3 concentration less than 16.13 ng 路ml-1 had the best effect in predicting GDM, its sensitivity was 73.0, specificity was 66.2 and Yorden index was 0.39. The area under the ROC curve was 0.717 / 95 and CI was 0.639 / 0.794m; Serum 25 at 24 weeks gestation. [OH] D3 concentration less than 14.84 ng 路ml-1 had the best effect in predicting GDM, its sensitivity was 67.0, specificity was 77.9 and Yorden index was 0.45. The area under the ROC curve was 0.723 ~ 95 CI = 0.645 ~ 0.8010.Conclusion the serum of pregnant women with ROC is 25%. [The concentration of OH] D3 decreased significantly, and vitamin D deficiency was associated with the onset of GDM. The diagnostic efficiency of GDM in two periods was the same, and the serum 25 at the 20th week of gestation. [The best diagnostic critical point of OH] D _ 3 concentration was 16.13 ng 路ml ~ (-1) 路L ~ (-1) 路L ~ (-1).
【作者单位】：溧阳市妇幼保健院检验科;
【分类号】：R714.256
【正文快照】： 妊娠期糖尿病(gestational diabetes mellitus,GDM)指妊娠期首次发生或发现的不同程度的糖代谢异常[1],是一种妊娠期最常见的并发症,对母婴均会产生不良影响[2],因此,其发病机制的研究备受重视,很多危险因素也逐渐被发现。近年来,关于维生素D缺乏引起糖尿病机制的研究发现,25-

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