| Autor: |
Emma L. Jamieson, Erica P. Spry, Andrew B. Kirke, Carly Roxburgh, David N. Atkinson, Julia V. Marley |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Journal of Clinical & Translational Endocrinology, Vol 23, Iss , Pp 100247- (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2214-6237 |
| DOI: |
10.1016/j.jcte.2020.100247 |
| Popis: |
Aims: Preanalytical glycolysis in oral glucose tolerance tests (OGTT) leads to substantial underestimation of gestational diabetes mellitus (GDM) and hence risk for large-for-gestational-age (LGA) babies. This paper quantified the impact of glycolysis on identification of LGA risk in a prospective rural and remote Australian cohort. Methods: For 495 women, OGTT results from room temperature fluoride-oxalate (FLOX) tubes were algorithmically corrected for estimated glycolysis compared to 1) the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study protocol (FLOX tubes in ice-slurry); and 2) room temperature fluoride-citrate (FC) tubes. GDM was defined by International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Unadjusted and corrected OGTT were related to LGA outcome. Results: Correction for FC tubes increased GDM incidence from 9.7% to 44.6%. After correction for HAPO protocol, GDM incidence was 27.7% and prediction of LGA risk (RR 1.82, [1.11–2.99]) improved compared to unadjusted rates (RR 1.12, [0.51–2.47]). To provide similar results for FC tube correction (29.3% GDM; RR 1.81, [1.11–2.96]) required + 0.2 mmol/L adjustment of IADPSG criteria. Conclusions: FC tubes present a practical alternative to the HAPO protocol in remote settings but give + 0.2 mmol/L higher glucose readings. Modification of IADPSG criteria would reduce perceived ‘overdiagnosis’ and improve LGA risk-assessment. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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