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Prediction of glucose intolerance at 24-28 weeks of gestation by glucose and insulin level measurements in the first trimester.

Fahami F, Torabi S, Abdoli S - Iran J Nurs Midwifery Res (2015 Jan-Feb)

Bottom Line: P < 0.05 was considered significant.In this study, 15 subjects (17%) were detected with a positive GCT result.Based on the results, the best cutoff points for FPG and FPI are 79.5 mg/dl and 7.55 μIU/ml, with accuracy of 60-67% and specificity of 45.2-47%.

View Article: PubMed Central - PubMed

Affiliation: Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: Gestational diabetes is the second common disorder in pregnancy period, which is detected in 24-28 weeks of gestational age through screening tests in low-risk women. The women with gestational diabetes are prone to prenatal mortality and development of future diabetes. Therefore, detection of these individuals in the first trimester and conducting preventive interventions is of great importance. This study aimed to define the predictive value of fasting plasma glucose (FPG) and fasting plasma insulin (FPI) test in first trimester concerning the positive result of oral glucose challenge test (OGCT).

Materials and methods: This is a prospective and observational study conducted on 88 pregnant women in Tehran. After FPG and FPI measurements in these women in the first trimester, a screening test of GCT with 50 g oral glucose was conducted in 24-28 weeks of gestational age. Diagnostic value of FPG and in these two groups of positive and normal GCT results was evaluated through receiver operator characteristic (ROC) curve. P < 0.05 was considered significant.

Results: In this study, 15 subjects (17%) were detected with a positive GCT result. The sub-curve area of ROC diagram for FPG and FPI was calculated to be 0.573and 0.592, respectively, which reveals that FPG and FPI cannot have a proper predictive value for the positive result of GCT. Based on the results, the best cutoff points for FPG and FPI are 79.5 mg/dl and 7.55 μIU/ml, with accuracy of 60-67% and specificity of 45.2-47%.

Conclusions: Only higher fasting glucose levels in early pregnancy, within the normoglycemic range, would predict the development of glucose intolerance with limited sensitivity and specificity.

No MeSH data available.


Related in: MedlinePlus

ROC sub-curve area for the ability of FPG in prediction of positive GCT.
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Figure 1: ROC sub-curve area for the ability of FPG in prediction of positive GCT.

Mentions: Independent t-test showed no significant difference in age in the two groups (t = 0.07). Mean primary BMI in normal and positive GCT groups were 21.90 (1.65) and 22.20 (2.04), respectively. Despite higher BMI found in positive GCT women, independent t-test showed no significant difference (t = 0.6). Mean ranks of pregnancy and delivery in normal and positive CGT groups were 1.79 (0.83) and 0.63 (0.63), and 1.8 (0.56) and 0.67 (0.61), respectively. Independent t-test showed no significant difference in pregnancy and delivery ranks in the two groups (t = 0.2). Mean FPG levels at 8–13 weeks of gestation in normal and positive GCT groups were 80.48 (8021) and 82.80 (9.3), respectively. Despite a higher level of FPG found in positive GCT group, independent t-test showed no significant difference (t = 0.97) [Table 1]. ROC was calculated as 0.573 for the prediction ability of FPG [Figure 1]. Based on this curve, the best cutoff point for FPG was 79.5 mg/dl with a sensitivity of 60% and specificity of 45.2%. The obtained positive and negative predictive values were 18.4% and 84.6%, respectively. In the present study, mean FPG values obtained in normal and positive GCT groups were 11.65 (7.11) and 8.92 (4.6), respectively. Mean FPI levels in the two groups of normal and positive gestational diabetes screening test showed no significant difference (t = 1.41). It was notable that mean FPI in positive GCT group was less than in normal GCT group. ROC for FPI prediction ability was 0.592 [Figure 2]. Based on this curve, the best cutoff point for FPI was obtained as 7.55 mg/dl with a sensitivity of 67%, specificity of 47%, positive predictive value of 22.6%, and negative predictive value of 86%.


Prediction of glucose intolerance at 24-28 weeks of gestation by glucose and insulin level measurements in the first trimester.

Fahami F, Torabi S, Abdoli S - Iran J Nurs Midwifery Res (2015 Jan-Feb)

ROC sub-curve area for the ability of FPG in prediction of positive GCT.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325419&req=5

Figure 1: ROC sub-curve area for the ability of FPG in prediction of positive GCT.
Mentions: Independent t-test showed no significant difference in age in the two groups (t = 0.07). Mean primary BMI in normal and positive GCT groups were 21.90 (1.65) and 22.20 (2.04), respectively. Despite higher BMI found in positive GCT women, independent t-test showed no significant difference (t = 0.6). Mean ranks of pregnancy and delivery in normal and positive CGT groups were 1.79 (0.83) and 0.63 (0.63), and 1.8 (0.56) and 0.67 (0.61), respectively. Independent t-test showed no significant difference in pregnancy and delivery ranks in the two groups (t = 0.2). Mean FPG levels at 8–13 weeks of gestation in normal and positive GCT groups were 80.48 (8021) and 82.80 (9.3), respectively. Despite a higher level of FPG found in positive GCT group, independent t-test showed no significant difference (t = 0.97) [Table 1]. ROC was calculated as 0.573 for the prediction ability of FPG [Figure 1]. Based on this curve, the best cutoff point for FPG was 79.5 mg/dl with a sensitivity of 60% and specificity of 45.2%. The obtained positive and negative predictive values were 18.4% and 84.6%, respectively. In the present study, mean FPG values obtained in normal and positive GCT groups were 11.65 (7.11) and 8.92 (4.6), respectively. Mean FPI levels in the two groups of normal and positive gestational diabetes screening test showed no significant difference (t = 1.41). It was notable that mean FPI in positive GCT group was less than in normal GCT group. ROC for FPI prediction ability was 0.592 [Figure 2]. Based on this curve, the best cutoff point for FPI was obtained as 7.55 mg/dl with a sensitivity of 67%, specificity of 47%, positive predictive value of 22.6%, and negative predictive value of 86%.

Bottom Line: P < 0.05 was considered significant.In this study, 15 subjects (17%) were detected with a positive GCT result.Based on the results, the best cutoff points for FPG and FPI are 79.5 mg/dl and 7.55 μIU/ml, with accuracy of 60-67% and specificity of 45.2-47%.

View Article: PubMed Central - PubMed

Affiliation: Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: Gestational diabetes is the second common disorder in pregnancy period, which is detected in 24-28 weeks of gestational age through screening tests in low-risk women. The women with gestational diabetes are prone to prenatal mortality and development of future diabetes. Therefore, detection of these individuals in the first trimester and conducting preventive interventions is of great importance. This study aimed to define the predictive value of fasting plasma glucose (FPG) and fasting plasma insulin (FPI) test in first trimester concerning the positive result of oral glucose challenge test (OGCT).

Materials and methods: This is a prospective and observational study conducted on 88 pregnant women in Tehran. After FPG and FPI measurements in these women in the first trimester, a screening test of GCT with 50 g oral glucose was conducted in 24-28 weeks of gestational age. Diagnostic value of FPG and in these two groups of positive and normal GCT results was evaluated through receiver operator characteristic (ROC) curve. P < 0.05 was considered significant.

Results: In this study, 15 subjects (17%) were detected with a positive GCT result. The sub-curve area of ROC diagram for FPG and FPI was calculated to be 0.573and 0.592, respectively, which reveals that FPG and FPI cannot have a proper predictive value for the positive result of GCT. Based on the results, the best cutoff points for FPG and FPI are 79.5 mg/dl and 7.55 μIU/ml, with accuracy of 60-67% and specificity of 45.2-47%.

Conclusions: Only higher fasting glucose levels in early pregnancy, within the normoglycemic range, would predict the development of glucose intolerance with limited sensitivity and specificity.

No MeSH data available.


Related in: MedlinePlus