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目的探讨糖化白蛋白(GA)和脂联素(APN)联合检测在诊断妊娠期糖尿病(GDM)中的临床价值。方法根据美国糖尿病协会(ADA)建议,以口服75 g葡萄糖耐量试验(OGTT)测定值作为诊断GDM的标准,采用液态酶法和酶联免疫吸附试验(ELISA)分别测定82例妊娠期糖尿病(24周~26周)患者,30例正常妊娠女性的空腹GA、APN水平,同时用葡萄糖氧化酶法测定空腹血糖(FPG)、餐后1 h血糖(1 h PG)和餐后2 h血糖(2 h PG)。结果 GDM组GA、FPG、1 h PG和2 h PG水平显著高于正常妊娠组,APN水平显著低于正常妊娠组(P<0.05)。单独检测GA或APN,灵敏性、特异性、阳性预测值和阴性预测值较低,两者联合检测能提高其阳性率。结论妊娠期高GA和低APN水平与GDM的发生和发展密切相关,结合2个指标,可以预测GDM的发生。
Objective To investigate the clinical value of combined detection of glycated albumin (GA) and adiponectin (APN) in the diagnosis of gestational diabetes mellitus (GDM). Methods According to the recommendations of the American Diabetes Association (ADA), oral g 75g glucose tolerance test (OGTT) was used as the standard for diagnosis of GDM. 82 cases of gestational diabetes mellitus (24 cases) were tested by liquid enzyme method and enzyme linked immunosorbent assay (ELISA) Week ~ 26 weeks). Fasting plasma glucose and APN levels were measured in 30 normal pregnant women. Fasting plasma glucose (FPG), postprandial blood glucose (1 h PG) and postprandial blood glucose (2 h) were measured by glucose oxidase h PG). Results The levels of GA, FPG, 1 h PG and 2 h PG in GDM group were significantly higher than those in normal pregnancy group, while the APN levels in GDM group were significantly lower than those in normal pregnancy group (P <0.05). GA or APN alone, sensitivity, specificity, positive predictive value and negative predictive value is low, the combination of the two can increase the positive rate. Conclusions High GA and low APN levels during pregnancy are closely related to the occurrence and development of GDM. Combined with two indexes, the occurrence of GDM can be predicted.