Glucose Disposal Index Predicts Adverse Pregnancy Outcomes in Gestational Diabetes.

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Alternative therapies in health and medicine Pub Date : 2024-10-01

Bo Yan, Yuan Yao

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Abstract

Objective: To explore the prognostic significance of the Glucose Disposal Index (DI) concerning unfavorable pregnancy outcomes in mothers and newborns affected by Gestational Diabetes Mellitus (GDM).

Methods: Our investigation encompassed 75 GDM patients who received treatment at Anhui Mingguang People's Hospital between January 2019 and July 2023. Subjects were divided into two groups: those with adverse pregnancy outcomes (n = 18) and those without (n = 57). Between weeks 24 and 28 of gestation, all participants underwent a 75 g Oral Glucose Tolerance Test (OGTT), and relevant details such as height, weight, and complete pregnancy information were gathered. The Insulin Sensitivity Index (ISI) and the area beneath the insulin-to-glucose curve from 0 to 120 minutes (AUC_INS120/AUC_GLU120) were computed from the 75 g OGTT findings, and their multiplication was represented as DI. Comparisons between groups were made using t tests, Wilcoxon rank-sum tests, and χ2 tests. Binary logistic regression was applied to probe the relationship between DI and the risk of adverse pregnancy outcomes, and the Receiver Operating Characteristic (ROC) curve was employed to evaluate the predictive capacity of DI.

Results: Statistically meaningful differences in FPG, HbA1c, and DI were noted between the groups (P < .05), whereas the difference in 2hPG was not significant (P > .05). Pearson correlation analysis revealed a negative correlation between DI and both FPG and HbA1c (P < .05). Multivariate logistic regression showed that DI (OR = 0.599) was a determining factor of adverse pregnancy outcomes (P < .05). The ROC curve disclosed an AUC of 0.837 for DI in forecasting adverse pregnancy outcomes (95% CI: 0.741-0.933), with a specificity of 82.10% and a sensitivity of 80.65% at the optimal threshold value of 2.1.

Conclusion: An elevation in DI among GDM patients is closely linked to a reduced risk of adverse pregnancy outcomes, corroborating DI's prognostic value for such outcomes in gestational diabetes.

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葡萄糖处置指数可预测妊娠糖尿病患者的不良妊娠结局。

目的探讨葡萄糖处置指数（DI）对妊娠期糖尿病（GDM）母亲和新生儿不利妊娠结局的预后意义：调查对象为2019年1月至2023年7月期间在安徽省明光市人民医院接受治疗的75例GDM患者。受试者分为两组：有不良妊娠结局者（n = 18）和无不良妊娠结局者（n = 57）。在妊娠第24周至28周期间，所有参与者都接受了75克口服葡萄糖耐量试验（OGTT），并收集了相关详细资料，如身高、体重和完整的妊娠信息。根据 75 克 OGTT 结果计算胰岛素敏感指数（ISI）和 0 至 120 分钟胰岛素-葡萄糖曲线下面积（AUC_INS120/AUC_GLU120），两者相乘表示为 DI。组间比较采用 t 检验、Wilcoxon 秩和检验和 χ2 检验。采用二元逻辑回归探究 DI 与不良妊娠结局风险之间的关系，并采用接收者工作特征曲线（ROC）评估 DI 的预测能力：结果：两组间 FPG、HbA1c 和 DI 的差异有统计学意义（P < .05），而 2hPG 的差异无显著性意义（P > .05）。皮尔逊相关分析显示，DI 与 FPG 和 HbA1c 之间均呈负相关（P < .05）。多变量逻辑回归显示，DI（OR = 0.599）是不良妊娠结局的决定性因素（P < .05）。ROC 曲线显示，DI 预测不良妊娠结局的 AUC 为 0.837（95% CI：0.741-0.933），在最佳临界值 2.1 时，特异性为 82.10%，灵敏度为 80.65%：GDM患者DI的升高与不良妊娠结局风险的降低密切相关，证实了DI对妊娠糖尿病不良妊娠结局的预后价值。

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来源期刊

Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

0.90

自引率

0.00%

发文量

219

期刊介绍： Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.