REPRODUCIBILITY OF THE ORAL GLUCOSE-TOLERANCE TEST IN PREGNANT-WOMEN

被引:65
作者
CATALANO, PM
AVALLONE, DA
DRAGO, NM
AMINI, SB
机构
[1] Department of Reproductive Biology Case Western Reserve University, MetroHealth Medical Center Cleveland, OH
关键词
ORAL GLUCOSE TOLERANCE TEST; PREGNANCY; GESTATIONAL DIABETES;
D O I
10.1016/0002-9378(93)90019-F
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: The purpose of this study was to evaluate the reproducibility of the 3-hour oral glucose tolerance test during pregnancy and the potential factors associated with nonreproducible results. STUDY DESIGN: Thirty-eight women with a 1-hour glucose level greater-than-or-equal-to 135 mg/dl had a 100 gm oral glucose tolerance test. During the test samples were obtained for glucose, insulin, cortisol, human placental lactogen, and norepinephrine levels, The oral glucose tolerance test was repeated 1 week later under similar metabolic conditions. RESULTS: The intraassay coefficient of variation in glucose from week 1 to week 2 was <2%. There were no significant differences in the paired fasting l-, 2-, or 3-hour glucose concentrations (p = 0.51 to 0.96) or the area under the glucose curve (p = 0.43) from week 1 to week 2, although the mean absolute difference in glucose values ranged from 4 (fasting) to 18 (3 hours) mg/dl. Oral glucose tolerance test results were classified as either normal or abnormal from week 1 to week 2: 16 normal/normal, 13 abnormal/abnormal, seven abnormal/normal, and two normal/abnormal. Norepinephrine (p = 0.03) and insulin (p = 0.05) were significantly greater in week 1 but not in week 2 in the abnormal/normal versus normal/normal and abnormal/abnormal groups. There were no significant differences in cortisol or human placental lactogen levels among groups at any time. CONCLUSIONS: The oral glucose tolerance test was not reproducible for diagnosis in 24% (nine of 38) of pregnant women. We speculate that maternal stress (increased norepinephrine) may have been a factor for the abnormal results in week 1 in the abnormal/normal group.
引用
收藏
页码:874 / 881
页数:8
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