AN EVALUATION OF FRUCTOSAMINE ESTIMATION IN SCREENING FOR GESTATIONAL DIABETES-MELLITUS
AN EVALUATION OF FRUCTOSAMINE ESTIMATION IN SCREENING FOR GESTATIONAL DIABETES-MELLITUS
复制标题
DOI：
10.1111/j.1464-5491.1995.tb00574.x
复制
发表时间：
1995-08-01
影响因子：
3.5
通讯作者：
MORRISON, J
中科院分区：
文献类型：
--
作者：
HUGHES, PF;AGARWAL, M;MORRISON, J
尽管反对妊娠期糖尿病(CDM)常规筛查的论据很有说服力，但作为产前护理的一部分，它被广泛但不是普遍地进行。目前还没有关于筛查(或诊断)的方法或标准的国际共识，而且在繁忙的产前诊所环境中，实施葡萄糖负荷方法有很大的实际困难。然而，最近的证据支持这样一个概念，即对CDM的诊断给予更高水平的重视，对成人疾病的胎儿和新生儿起源的兴趣被添加到怀孕期间短期的产科和胎儿关注中。在一家繁忙的、多种族的产前诊所，第二代果糖胺检测(经总蛋白校正)已被评估为GDM葡萄糖筛查的实用替代品。用Carpenter的改良标准进行糖耐量试验，诊断CDM的敏感度为79.4%，特异度为77.3%。考虑到这一样本/检测要求的组织简单性，建议进行更广泛的评估，同时重新评估临床结果标准，而不仅仅是血糖水平。
Although persuasive arguments against routine screening for gestational diabetes mellitus (CDM) have been made, it is widely but not universally performed as a part of antenatal care. There is no international agreement on methods or criteria used for screening (or for diagnosis), and administered glucose-load methods have significant practical difficulties in a busy antenatal clinic setting. However, recent evidence supports the concept of an increased level of importance being given to a diagnosis of CDM, with interest in the fetal and neonatal origins of adult disease being added to the short-term obstetric and fetal concern during pregnancy. A second generation fructosamine test, corrected for total protein, has been evaluated as a practical alternative to glucose screening for GDM in a busy, multi-ethnic antenatal clinic. This achieved a 79.4 % sensitivity and a 77.3 % specificity for a diagnosis of CDM confirmed by a glucose tolerance test using Carpenter's modified criteria. In view of the organizational simplicity of this sample/test requirement, a wider evaluation is suggested together with a re-evaluation of clinical outcome criteria rather than blood glucose levels alone.