1,5-ANHYDROGLUCITOL AND NEONATAL COMPLICATIONS IN PREGNANCY COMPLICATED BY DIABETES

作者：Wright Lorena A^*; Hirsch Irl B; Gooley Ted A; Brown Zane

来源：Endocrine Practice, 2015, 21(7): 725-733.

DOI：10.4158/EP14437.OR

Objective: To determine the association of 1,5-anhydroglucitol (1,5-AG) with neonatal birth weight (NBW) and neonatal hypoglycemia (+NH) in pregnancies complicated by diabetes.
Methods: We assessed a retrospective cohort of 102 females, 17 with gestational diabetes (GDM), 48 with type 1 diabetes mellitus (T1DM), and 37 with type 2 diabetes mellitus (T2DM). 1,5-AG and glycated hemoglobin A1C (A1C) values throughout pregnancy were extracted. Linear regression was used to assess their association with NBWs z-scores adjusting for maternal age, ethnicity and body mass index (BMI). +NH was defined by a note in the infant record, glucose <1.7 mmol/L in the first 24 h, or <2.5 mmol/L in the first 48 h after birth. A t test or Welch's approximate t test was used to compare the mean 1,5-AG and A1C of mothers with +NH versus those without (-NH), adjusted for gestational age and analyzed by diabetes type and across trimesters.
Results: Mean 1,5-AG significantly differed across groups: T1DM 3.77 +/- 2.82 mu g/mL, T2DM 5.73 +/- 4.38 mu g/mL, GDM 8.89 +/- 4.39 mu g/mL (P<.0001), suggesting less glucose exposure in GDM relative to T1DM or T2DM. A negative linear association was found between mean 1,5-AG and z-scores (R=-0.28, P=.005. In contrast, the association between mean A1C and z-scores was weaker (R = 0.15, P=.14). The mean 1,5-AG tended to be lower in the +NH cohort versus -NH (P =.08), and this was statistically significant (P=.01) among subjects with GDM.
Conclusion: The association of 1,5-AG with complications related to glycemic exposure supports the notion of its utility as an adjunct glycemic biomarker in pregnancies complicated by diabetes and across trimesters.

• 出版日期2015-7