妊娠早期妊娠期糖尿病预测模型的构建与验证

doi:10.3969/j.issn.1671-7171.2025.04.021

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摘要【目的】构建妊娠早期妊娠期糖尿病(gestational diabetes mellitus,GDM)预测模型并验证。【方法】回顾性分析2021年3月至2022年6月上海交通大学医学院附属第六人民医院南院妇产科收治的1008例孕妇的资料,其中GDM孕妇426例(GDM组),健康孕妇582例(NGT组)。收集所有孕妇的临床资料和孕早期相关指标,采用多因素 Logistic 回归分析GDM发生的危险因素,构建妊娠早期GDM的预测模型并验证。【结果】多因素 Logistic 回归分析显示:孕妇年龄、空腹血糖、糖化血红蛋白、甘油三酯、白细胞计数、血红蛋白和中性粒细胞与淋巴细胞比值均是GDM发生的危险因素(P<0.05)。据此构建列线图的模型ROC曲线下面积(AUC)为0.882(95%CI:0.857~0.907),表明该模型具有良好的预测效能;Hosmer-Lemeshow检验结果中χ²=7.147,P=0.521,提示预测模型预测 GDM 发生概率与实际诊断为 GDM具有良好的一致性。【结论】本研究构建的含有7个自变量的妊娠早期预测GDM发生模型,有助于临床筛选高风险孕妇,及早进行干预,以降低GDM发生率和不良并发症的发生率。

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	王和祥
	刘彦彦
	陆欢

关键词 ：糖尿病妊娠, 妊娠初期, 预测

Abstract：【Objective】This study aims to develop a predictive model based on clinical factors and selected biochemical markers for the early risk assessment of gestational diabetes mellitus (GDM). 【Methods】The data of 1008 pregnant women admitted to the South Campus of Shanghai Sixth People's Hospital, which is affiliated to Shanghai Jiaotong University, from March 2021 to June 2022 were retrospectively analyzed, including 426 cases of gestational diabetes mellitus (the GDM group) and 582 cases of healthy pregnant women (the NGT group). The clinical data and related indicators in early pregnancy of all pregnant women were collected, multivariate Logistic regression analysis was used to explore the risk factors associated with GDM, and the prediction model was constructed and verified. 【Results】Multivariate logistic regression analysis showed that the age, fasting blood glucose, glycosylated hemoglobin, triglyceride, white blood cell count, hemoglobin, and neutrophil lymphocyte ratio of pregnant women were the risk factors for diabetes in pregnancy (P<0.05). Based on these information, the column chart model was constructed;The area under the ROC curve (AUC) of this model was 0.882 (95%CI:0.857-0.907), which indicated that the model had good predictive performance. The Hosmer-Lemeshow test results showed χ²=7.147 and P=0.521, indicating good consistency between the predicted probability of GDM occurrence by the predictive model and the actual diagnosis probability. 【Conclusion】The model constructed in this study contains 7 independent variables to predict the occurrence of diabetes in the early pregnancy, which is helpful for clinical screening of high-risk GMD pregnant women, early intervention to reduce the occurrence of diabetes in pregnancy and reducing adverse complications.

Key words： Diabetes Gestational Pregnancy Trimester First Forecasting

收稿日期: 2024-11-22

中图分类号:

R714.256

通讯作者: ^*E-mail:luhuan2021@sjtu.edu.cn

引用本文:

王和祥, 刘彦彦, 陆欢. 妊娠早期妊娠期糖尿病预测模型的构建与验证[J]. 医学临床研究, 2025, 42(4): 633-637.
WANG Hexiang, LIU Yanyan, LU Huan. Construction and Validation of Prediction Model for Gestational Diabetes Mellitus in Early Pregnancy. JOURNAL OF CLINICAL RESEARCH, 2025, 42(4): 633-637.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.04.021 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I4/633

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