目的 探讨糖化血红蛋白(HbA1c)与妊娠期糖尿病(GDM)的关系.方法 选取在我院产检的140例孕妇,根据中华医学会推荐的GDM诊断标准将其分为正常组(n=60)、糖耐量减低(GIGT)组(n=42)和GDM组(n=38),比较不同组别空腹血糖(FPG)、服葡萄糖后1 h血糖(1 hPG)、HbAlc及胰岛素抵抗指数(HOMA-IR)差异,并比较不同HbAlc水平与妊娠期母婴并发症的关系.结果 GDM组孕妇的FPG、1 hPG、HbAlc及HOMA-IR比正常组和GIGT组孕妇的明显升高,差异均有统计学意义(P<0.05);HbA1c>6%组孕妇早产、胎膜早破、胎儿宫内窘迫发生率明显高于≤6%组孕妇,差异均有统计学意义(P<0.05);Spearman相关性分析显示HbAlc水平与HOMA-IR呈正相关性(P<0.05).结论 HbA1c可作为筛查孕妇GDM、反映血糖水平的可靠指标,其水平与GDM母婴并发症的发生有关,与胰岛素抵抗有正相关性.%Objective To investigate the relationship of hemoglobin A1c (HbA1c) with gestational diabetes mellitus (GDM). Methods One hundred and forty pregnant women were divided into normal group (n=60), gesta-tional impaired glucose tolerance (GIGT) group (n=42), GDM group (n=38) according to GDM diagnostic criteria rec-ommended by Chinese Medical Association. The fasting plasma glucose (FPG), 1-h plasma glucose (1 hPG), HbAlc and insulin resistance index (HOMA-IR) were compared between different groups. The relationship of HbAlc levels with maternal complications was studied. Results FPG, 1 hPG, HbAlc and HOMA-IR in GDM group were significant-ly higher than those in the normal group and GIGT group (P<0.05). The rate of preterm, premature rupture of mem-branes, intrauterine distress in HbA1c>6%group were significantly higher than HbA1c≤6%group, and the differences were of statistically significance (P<0.05). Spearman correlation analysis showed that HbAlc was positively correlated with HOMA-IR (P<0.05). Conclusion HbA1c is a reliable indicator in GDM screening and reflecting blood glucose levels, which related with maternal complications of GDM, and is of a positive correlation with insulin resistance.
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