Srimaekarat Thanarat
Department of Obstetrics and Gynecology, Trang Regional Hospital, Muang, Trang, Thailand.
J Med Assoc Thai. 2009 Oct;92(10):1268-72.
To determine optimal threshold of capillary blood glucose screening (Accu-Chek Advantage) for gestational diabetes.
A cross-sectional analytical study.
Capillary and venous blood of pregnant women who attended the antenatal clinic at Trang Regional Hospital between August 2007 and May 2008 were collected for glucose testing (by approach of American Diabetes Association's Fourth International Workshop-Conference on Gestational Diabetes) at one hour after taking 50 gm glucose. The glucose values of Accu-Check Advantage were compared with the standard venous plasma glucose. The receiver operator characteristic (ROC) curve was created to determine the optimal threshold of the capillary blood test screening for gestational diabetes.
A total of 816 pregnant women were enrolled in the present study. Their capillary blood glucose values and plasma glucose values were checked with the Accu-Chek Advantage and the central laboratory chemistry analyzer respectively. The good correlation between capillary blood glucose and plasma glucose values was found (correlation coefficient = 0.80, 95% CI 0.77-0.82). There was a significant difference in the average values of capillary blood and plasma blood (134.1 vs. 122.7 mg/dl, respectively). When the data were analyzed by ROC curve, the optimal level of capillary blood by Accu-Chek Advantage for performing a 100 gm oral glucose tolerance test was 140 mg/dl (reference plasma glucose level of at least 140 mg/dl). The sensitivity specificity likelihood ratio for a positive test result and likelihood ratio for a negative test result were 93.8%, 83.6%, 5.71 and 0.07, respectively. The potential advantages of capillary blood glucose screening are simple to use, cheap and convenient.
Accu-Chek Advantage is suitable for screening gestational diabetes using the optimal threshold capillary glucose level of 140 mg/dl.
确定用于筛查妊娠期糖尿病的毛细血管血糖（罗氏卓越血糖仪）最佳阈值。
一项横断面分析研究。
收集2007年8月至2008年5月在董里地区医院产前门诊就诊的孕妇的毛细血管血和静脉血，在服用50克葡萄糖1小时后进行血糖检测（采用美国糖尿病协会第四届妊娠期糖尿病国际研讨会的方法）。将罗氏卓越血糖仪测得的血糖值与标准静脉血浆葡萄糖值进行比较。绘制受试者工作特征（ROC）曲线以确定用于筛查妊娠期糖尿病的毛细血管血糖检测的最佳阈值。
本研究共纳入816名孕妇。分别使用罗氏卓越血糖仪和中心实验室化学分析仪检测她们的毛细血管血糖值和血浆葡萄糖值。发现毛细血管血糖值与血浆葡萄糖值之间具有良好的相关性（相关系数 = 0.80，95%可信区间0.77 - 0.82）。毛细血管血和血浆血的平均值存在显著差异（分别为134.1和122.7毫克/分升）。当通过ROC曲线分析数据时，罗氏卓越血糖仪用于进行100克口服葡萄糖耐量试验的毛细血管血糖最佳水平为140毫克/分升（参考血浆葡萄糖水平至少为140毫克/分升）。阳性检测结果的敏感度、特异度、阳性似然比和阴性似然比分别为93.8%、83.6%、5.71和0.07。毛细血管血糖筛查的潜在优点是使用简单、价格便宜且方便。
罗氏卓越血糖仪适用于使用140毫克/分升的最佳毛细血管血糖水平阈值筛查妊娠期糖尿病。
