Glycohemoglobin A1c: A promising screening tool in gestational diabetes mellitus.
Glycohemoglobin A1c: A promising screening tool in gestational diabetes mellitus.
复制标题
DOI：
10.4103/0973-3930.45271
复制
发表时间：
2008-10
影响因子：
0.9
通讯作者：
Gossain VV
中科院分区：
文献类型：
--
作者：
Aldasouqi SA;Solomon DJ;Bokhari SA;Khan PM;Muneera S;Gossain VV
目前妊娠糖尿病（GDM）的筛查测试并不方便。因此，GDM 的替代筛查试验是可取的。使用糖化血红蛋白 A1c (HbA1c) 筛查 GDM 仍存在争议。我们进行这项研究是为了评估 HbA1c 在 GDM 筛查中的效用。某三级教学医院的回顾性研究。审查实验室记录以确定在 16 个月期间接受口服葡萄糖耐量试验 (OGTT) 和 HbA1c 测量的孕妇。评估了 OGTT 与 HbA1c 的关联。使用 SPSS 软件收集数据。进行了平均值的比较和灵敏度的计算。根据 OGTT，145 名符合条件的患者中，124 名患有 GDM，21 名患者没有。 HbA1c 值（参考范围 4.8%–6.0%）等于或高于连续切点值 5.0%、5.5%、6.0%、6.5% 和 7.0%（即敏感性值）的患者百分比分别为 100%、98.4%、87.1%、62.9% 和 39.5%。 GDM 患者的平均 HbA1c 为 6.9 ± 0.8%，而非 GDM 患者的平均 HbA1c 为 6.4 ± 0.6%（P < 0.006）。在 6.0%（正常上限）的任意临界值下，HbA1c 会发现 87.1% 的 GDM 患者。这项研究表明，HbA1c 是这一高危人群中 GDM 的一项相当敏感的筛查指标。承认研究设计的局限性，有必要进行进一步的前瞻性研究来验证这一结论，并评估 HbA1c 作为 GDM 筛查测试的特异性。
Current screening tests for gestational diabetes mellitus (GDM) are inconvenient. Therefore, alternative screening tests for GDM are desirable. The use of glycohemoglobin A1c (HbA1c) in screening for GDM remains controversial. We undertook this study to evaluate the utility of HbA1c in screening for GDM. Retrospective study in a tertiary teaching hospital. Laboratory records were reviewed to identify pregnant women who underwent both oral glucose tolerance test (OGTT) and HbA1c measurements over a 16-months period. The association of OGTT with HbA1c was evaluated. Data were collected using SPSS software. Comparisons of the means and calculations of sensitivities were performed. Of 145 eligible patients, 124 had GDM and 21 patients did not, per OGTT. The percentages of patients with HbA1c values (reference range of 4.8%–6.0%) equal to or above sequential cut-point values of 5.0%, 5.5%, 6.0%, 6.5% and 7.0% (i.e., sensitivity values) were 100%, 98.4%, 87.1%, 62.9% and 39.5%, respectively. The mean HbA1c of the patients with GDM was 6.9 + 0.8% compared to 6.4 + 0.6% for those without GDM (P< 0.006). At an arbitrary cut-off value of 6.0% (the upper limit of normal), HbA1c would have picked up 87.1% of patients with GDM. This study suggests that HbA1c is a reasonably sensitive screening measure of GDM in this high-risk population. Acknowledging limitations resulting from the study design, further prospective studies are warranted to verify this conclusion, and to evaluate the specificity of HbA1c as a screening test for GDM.