Uğurkan ERKAYIRAN, Selim KONCAGÜL, Zahide KÜÇÜK

Gebelerde 50 gr Oral Glukoz Tolerans Test Sonuçları ile Vücut Kitle İndeksinin Karşılaştırılması

Amaç: Vücut kitle indeksi ile Gestasyonel Diabetes Mellitus arasında doğrudan ilişki olduğu yapılan çalışmalarda gösterilmiştir. Bizim bu çalışmamızda amacımız 24-28 hafta gebeliği olan olgularımızın vücut kitle indeksleri ile 50 gram OGTT sonuçlarını karşılaştırmak ve vücut kitle indeksine göre zayıf, normal kilolu, fazla kilolu, obez ve morbid obez olarak sınıflandırdığımız gruplar arasındaki OGTT sonuçlarını değerlendirmektir. Gereç ve Yöntem: Bu çalışmaya 24-28 hafta gebeliği olan 200 hasta alındı. Hastalarımızın boy ve kilo ölçümleri yapıldı. Vücut Kitle İndeksleri hesaplanarak zayıf, normal, fazla kilolu, obez ve morbid obez olarak gruplara ayrıldı. 50 gram glukoz oral yoldan günün herhangi bir saatinde hastanın açlığı gözetilmeden uygulandı. vücut kitle indeksi ile 50 gram OGTT sonuçları karşılaştırıldı. Bulgular: OGTT sonrası glukoz değeri 140 mg/dl ve üzerinde olan grupta, glukoz değeri 140 mg/dl’den düşük olan gruba göre, vücut kitle indeksi düzeyinin 30 kg/m2 ve daha yüksek olanların oranı istatistiksel olarak daha yüksek bulundu(p=0,048). Vücut kitle indeksi düzeyinin 25 kg/m2' den düşük olanların oranı, 50 gr OGTT sonucunda glukoz değeri 140 mg/dl’den düşük olan grupta, OGTT deki glukoz değeri 140 mg/dl ve üzerinde olan gruba göre istatistiksel olarak daha yüksek bulundu(p=0,015). OGTT değeri 140 mg/dl’den düşük olan grup ile OGTT değeri 140 mg/dl ve üzerinde olan grup arasında, vücut kitle indeksi 25-29,9 arasında olanların oranı istatistiksel olarak benzer bulundu (p=0,581). Sonuç: Obezite, GDM için ciddi bir risk faktörüdür. Vücut kitle indeksi 30 kg/m2 ve üstünde olan gebeler ilk antepartum vizitte diabet açısından taranmalı eğer herhangi patolojik bir duruma rastlanılmazsa, 50 gram OGTT 24-28. gebelik haftalarında tekrarlanılmalıdır. Bu hastaların antenatal kontrolleri daha sık yapılmalı ve mümkünse endokrinolog, diyetisyen ve kadın doğum uzmanından oluşan sabit bir ekipçe sürdürülmelidir.

Anahtar Kelimeler:

Vücut kitle indeksi, OGTT 50 gr, Gestasyonel Diabetes Mellitus

The Comparison of the 50 gr Oral Glucose Tolerrance Test Results with the Body Mass Index in the Pregnancy Period of Women

Objectives: The direct corellation between body mass index and gestational diabetes mellitus has been shown in recent studies. In this study, our aim is to compare our cases’ body mass index with the results of 50 grams OGTT who have 24-28 weeks gestation and to evaluate the OGTT results of the groups which are categorized as weak, normal weight, overweight, obese and morbidly obese according to body mass index. Materials and Methods: There were included 200 patients who referred to our hospital as having a 24-28 weeks gestation. Our patients’ height and weight measuements were performed. By calculating body mass index, they were grouped as weak, normal weight, overweight, obese and morbidly obese 50 grams of glucose were applied orally at any time of the day without considering patient’s hunger.Body mass index and OGTT results were examined by comparing. Results: In the group of patients who had lower body mass index value than 25 kg/m2 , it was seen that the rate of patients who have lower OGTT value than 140 mg/dl was statistically much more than others. Between the group of patients who have lower OGTT value than 140 mg/dl and the group of patients who have 140 mg/dl and higher, the rate of patients who have body mass index value between 25 and 25.9 was found statistically similar. Considering the group which had lower OGTT value than 140 mg/dl, the rate of patients who have 30 kg/ m2 and higher body mass index level was statistically higher in the group which has 140 mg/dl and higher. Conclusion: Obesity is a serious risk factor for gestational diabetes mellitus. Pregnant women who have 30 kg/ m2 and higher body mass index value should be tested for diabets at the first antepartum visit and if there is not encountered any pathological situation 50 grams OGTT should be repeated in 24-28 weeks gestation.

Keywords:

body mass index, oral glucose tolerance test 50 gr, gestational dibetes mellitus,

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