HbA1c在妊娠期糖尿病筛查中的临床价值

摘要

Objective To evaluate the application probability of glycosylated hemoglobin A1c (HbA1c) in the screening of gestational diabetes mellitus (GDM).Methods 474 pregnant women during pregnant 24-28 weeks were classified into GDM group (30 cases) and non-GDM group (444 cases) according to American Diabetes Association (ADA) guidelines, and they had 75 g oral glucose tolerance test (OGTT) and HbA1c measurement.The results of HbA1c tests between GDM and non-GDM pregnant women were analyzed.Results HbA1c level in GDM group was higher than that in non-GDM group ( P ＜ 0.01 ).The area under receiver operating characteristic ( ROC ) curve was 0.969.When the cut-off value was 5.4％, the results showed sensitivity 73.0％ and specificity 98.4％.The positive predictive value was 75.9％, and the reliability was 98.2％.Conclusions HbAle is a promising indicator for detecting GDM.%目的 评估糖化血红蛋白(HbA1c)在妊娠期糖尿病(GDM)筛查中应用的可能性.方法 对同时进行75 g口服葡萄糖耐量试验(OGTT)和HbA1c检查的474例围产期门诊孕妇按美国糖尿病协会(ADA)标准分为GDM组(30例)和非GDM组(444例),分析2组HbA1c结果.结果 GDM组HbA1c水平明显高于非GDM组(P<0.01);HbA1c筛查GDM的受试者工作特征(ROC)曲线下面积为0.969;当HbA1c 的Cut-off值为5.4%时,筛查GDM的敏感性为73.0%、特异性为98.4%、阳性预示值为75.9%、可靠性为98.2%.结论 HbA1c可作为一个非常有希望的GDM筛查指标.