دورية أكاديمية
Predicting Progression from Gestational Diabetes to Impaired Glucose Tolerance Using Peridelivery Data: An Observational Study.
| العنوان: | Predicting Progression from Gestational Diabetes to Impaired Glucose Tolerance Using Peridelivery Data: An Observational Study. |
|---|---|
| المؤلفون: | Bengtson AM; Department of Epidemiology, Brown School of Public Health, Providence, Rhode Island., Dice ALE; Department of Epidemiology, Brown School of Public Health, Providence, Rhode Island., Clark MA; Department of Health Services, Policy and Practice; Brown School of Public Health, Providence, Rhode Island.; Department of Obstetrics and Gynecology, Women and Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island., Gutman R; Department of Biostatistics, Brown School of Public Health, Providence, Rhode Island., Rouse D; Department of Epidemiology, Brown School of Public Health, Providence, Rhode Island.; Department of Obstetrics and Gynecology, Women and Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island., Werner E; Department of Epidemiology, Brown School of Public Health, Providence, Rhode Island.; Department of Obstetrics and Gynecology, Women and Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. |
| المصدر: | American journal of perinatology [Am J Perinatol] 2024 May; Vol. 41 (S 01), pp. e282-e289. Date of Electronic Publication: 2022 Jun 16. |
| نوع المنشور: | Journal Article; Observational Study; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme-Stratton Country of Publication: United States NLM ID: 8405212 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-8785 (Electronic) Linking ISSN: 07351631 NLM ISO Abbreviation: Am J Perinatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Thieme-Stratton, 1983- |
| مواضيع طبية MeSH: | Diabetes, Gestational*/diagnosis , Diabetes, Gestational*/epidemiology , Glucose Intolerance*/diagnosis , Glucose Intolerance*/epidemiology , Glucose Intolerance*/blood , Disease Progression*, Humans ; Female ; Pregnancy ; Adult ; Glucose Tolerance Test ; Area Under Curve ; Blood Glucose/analysis ; Body Mass Index ; Glycated Hemoglobin/analysis ; Postpartum Period ; Diabetes Mellitus, Type 2 ; Predictive Value of Tests ; Risk Factors ; Sensitivity and Specificity |
| مستخلص: | Objective: This article aimed to develop a predictive model to identify persons with recent gestational diabetes mellitus (GDM) most likely to progress to impaired glucose tolerance postpartum. Study Design: We conducted an observational study among persons with GDM in their most recent pregnancy, defined by Carpenter-Coustan criteria. Participants were followed up from delivery through 1-year postpartum. We used lasso regression with k-fold cross validation to develop a multivariable model to predict progression to impaired glucose tolerance, defined as HbA1c≥5.7%, at 1-year postpartum. Predictive ability was assessed by the area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Results: Of 203 participants, 71 (35%) had impaired glucose tolerance at 1-year postpartum. The final model had an AUC of 0.79 (95% confidence interval [CI]: 0.72, 0.85) and included eight indicators of weight, body mass index, family history of type 2 diabetes, GDM in a prior pregnancy, GDM diagnosis<24 weeks' gestation, and fasting and 2-hour plasma glucose at 2 days postpartum. A cutoff point of ≥ 0.25 predicted probability had sensitivity of 80% (95% CI: 69, 89), specificity of 58% (95% CI: 49, 67), PPV of 51% (95% CI: 41, 61), and NPV of 85% (95% CI: 76, 91) to identify women with impaired glucose tolerance at 1-year postpartum. Conclusion: Our predictive model had reasonable ability to predict impaired glucose tolerance around delivery for persons with recent GDM. Key Points: · We developed a predictive model to identify persons with GDM most likely to develop IGT postpartum.. · The final model had an AUC of 0.79 (95% CI: 0.72, 0.85) and included eight clinical indicators.. · If validated, our model could help prioritize diabetes prevention efforts among persons with GDM.. Competing Interests: None declared. (Thieme. All rights reserved.) |
| معلومات مُعتمدة: | U01 DK123783 United States DK NIDDK NIH HHS |
| تواريخ الأحداث: | Date Created: 20220616 Date Completed: 20240514 Latest Revision: 20240729 |
| رمز التحديث: | 20240730 |
| DOI: | 10.1055/a-1877-9587 |
| PMID: | 35709723 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-8785 |
|---|---|
| DOI: | 10.1055/a-1877-9587 |