糖化血红蛋白用于诊断妊娠期糖尿病女性产后异常糖耐量：诊断性荟萃分析

Hemoglobin A1c for diagnosis of postpartum abnormal glucose tolerance among women with gestational diabetes mellitus: diagnostic meta-analysis.

作者信息

Su Xudong, Zhang Zhaoyan, Qu Xinye, Tian Yaqiang, Zhang Guangzhen

机构信息

Department of Endocrinology, Liaocheng People's Hospital, Liaocheng, China.

Department of Gynaecology and Obstetrics, Women and Children Hospital, Liaocheng, China.

出版信息

PLoS One. 2014 Jul 11;9(7):e102144. doi: 10.1371/journal.pone.0102144. eCollection 2014.

OBJECTIVE

To evaluate the accuracy of glycosylated hemoglobin A1c (HbA1c) for the diagnosis of postpartum abnormal glucose tolerance among women with gestational diabetes mellitus (GDM).

METHODS

After a systematic review of related studies, the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and other measures about the accuracy of HbA1c in the diagnosis of postpartum abnormal glucose tolerance were pooled using random-effects models. The summary receiver operating characteristic (SROC) curve was used to summarize the overall test performance.

RESULTS

Six studies met our inclusion criteria. The pooled results on SEN, SPE, PLR, NLR, and DOR were 0.36 (95% CI 0.23-0.52), 0.85 (95% CI 0.73-0.92), 2.4 (95% CI 1.6-3.6), 0.75 (95% CI 0.63-0.88) and 3 (95% CI 2-5). The area under the summary receiver operating characteristic (SROC) curve was 0.67 with a Q value of 0.63.

CONCLUSIONS

Measurement of HbA1c alone is not a sensitive test to detect abnormal glucose tolerance in women with prior GDM.

目的

评估糖化血红蛋白A1c（HbA1c）用于诊断妊娠期糖尿病（GDM）女性产后糖耐量异常的准确性。

方法

在对相关研究进行系统综述后，采用随机效应模型汇总关于HbA1c诊断产后糖耐量异常准确性的敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）及其他指标。采用汇总受试者工作特征（SROC）曲线总结总体检验效能。

结果

六项研究符合纳入标准。敏感性（SEN）、特异性（SPE）、PLR、NLR和DOR的汇总结果分别为0.36（95%可信区间0.23 - 0.52）、0.85（95%可信区间0.73 - 0.92）、2.4（95%可信区间1.6 - 3.6）、0.75（95%可信区间0.63 - 0.88）和3（95%可信区间2 - 5）。汇总受试者工作特征（SROC）曲线下面积为0.67，Q值为0.63。