Mehmet Mete KIRLANGIÇ, Belfin Nur ARİCİ HALİCİ

Obez Olmayan Gebe Kadınlarda Gestasyonel Diabetes Mellitus Tahmininde Birinci Trimester Açlık Kan Şekeri, HOMA-IR ve HbA1c Analizi: Bir Retrospektif Çalışma

Amaç: Gestasyonel Diabetes Mellitus (GDM), fetomaternal komorbiditeleri olan gebelikte en sık görülen endokrin komplikasyondur. GDM'nin erken tanısı için obez olmayan gebelerde ilk trimesterde açlık kan şekeri (AKŞ), insülin direnci homeostaz modeli değerlendirmesi (HOMA-IR), Hemoglobin A1c (HbA1c) değerlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Birinci trimester AKŞ, HOMA-IR, HbA1c değerleri ve ikinci trimester OGTT sonuçları olan gebeler hastane veri tabanından tarandı. İlk trimester boyu, kilosu, yaşı ve gebelik haftaları da kaydedildi. Vücut kütle indeksi (VKİ) 30 kg/m2'nin üzerindekiler, kronik ve sistemik hastalığı ve (GDM) öyküsü olanlar çalışmaya dahil edilmedi. ROC analizi AKŞ, HOMA-IR, HbA1c üzerinde yapıldı. Bulgular: Bu retrospektif çalışma 01/01/2021-01/01/2022 tarihleri arasında Tuzla Devlet Hastanesi Kadın Hastalıkları ve Doğum Kliniği'nde yapıldı. Dahil edilme kriterlerini karşılayan 131 hamile kadına ulaşıldı. Gebelerin yirmisi GDM pozitif (+) olarak değerlendirildi. Yaş, boy, kilo, VKİ, gebelik haftası, nulliparite gruplar arasında benzer olarak gözlendi. AKŞ, insülin, HOMA-IR, HbA1c değerleri GDM'li grupta daha yüksekti. ROC analizi sonucunda, AKŞ değeri 88,5 mg/dl (sensitivite %68.2, spesifite %68.2), HOMA-IR değeri 2.24 (sensitivite %63.6, spesifite %64.5) ve HbA1c değeri %5.25'in (sensitivite %68.2, spesifite %66.7) üzerinde olanların GDM için risk altında olduğu gözlenmiştir. Sonuç: Birinci trimester yüksek AKŞ, HOMA-IR ve HbA1c olan gebelerin GDM için yüksek risk taşıdığını ve GDM'nin bir göstergesi olarak kullanılabileceğini göstermiştir.

Anahtar Kelimeler:

FBG, FBG, GDM, GDM, GDM, GDM, HOMA-IR, HOMA-IR, HOMA-IR, HOMA-IR, HbA1c, HbA1c, HbA1c, HbA1c

Evaluation of First Trimester Fasting Blood Glucose, HOMA-IR and HbA1c in Prediction of Gestational Diabetes Mellitus in Non-Obese Pregnant Women: A Retrospective Study

Aim: Gestational Diabetes Mellitus (GDM) is the most common endocrine complication in pregnancy with fetomaternal comorbidities. It is aimed to evaluate fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), and hemoglobin A1c (HbA1c) values in the first trimester in non-obese pregnant women for early detection of GDM. Material and Methods: Pregnant women with first-trimester FBG, HOMA-IR, HbA1c values, and second-trimester OGTT results were scanned from the hospital database. First-trimester height, weight, age and gestational weeks were also recorded. The presence of Body Mass Index (BMI) over 30 kg/m2, chronic and systemic disease and history of G(DM) were not included in the study. ROC analysis was performed on FBG, HOMA-IR, and HbA1c. Results: This retrospective study was conducted between 01/01/2021, and 01/01/2022 in Tuzla State Hospital Gynecology and Obstetrics Clinic. 131 pregnant women who met the inclusion criteria were reached. Twenty of pregnant women were evaluated as GDM positive(+). Age, height, weight, BMI, gestational week, and nulliparity were observed to be similar between the groups. FBG, insulin, HOMA-IR, and HbA1c values were higher in the group with GDM. As a result of ROC analysis, those with an FBG value of 88,5 mg/dl (sensitivity 68.2%, specificity 68.2%), a HOMA-IR value of 2.24 (sensitivity 63.6%, specificity 64.5%), and a HbA1c (sensitivity 68.2%, specificity 66.7%) value of over 5.25% were observed to be at risk for GDM. Conclusion: It has shown that pregnant women with high first trimester FBG, HOMA-IR and HbA1c have a high risk for GDM and can be used as a predictor of GDM.

Keywords:

First Trimester, GDM, GDM, GDM, HOMA-IR, HOMA-IR, HOMA-IR, HOMA-IR, HbA1c, HbA1c, HbA1c, Prediction,

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