Li Hua-Ping, Wang Feng-Huan, Tao Min-Fang, Huang Ya-Juan, Jia Wei-Ping
Department of Gynecology & Obstetrics Shanghai Clinical Center for Diabetes Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China.
Department of Gynecology & Obstetrics Shenzhou City Hospital Shenzhou Hebei China.
J Diabetes Investig. 2016 Jan;7(1):48-55. doi: 10.1111/jdi.12383. Epub 2015 Jul 14.
AIMS/INTRODUCTION: To assess glycated albumin (GA) as a potential glycemic index in managing gestational diabetes mellitus (GDM).
Eligible pregnant women were divided into the GDM group with abnormal result on a 75-g oral glucose tolerance test (OGTT) and the control (normal) group. GA measurements, Pearson's correlation analysis, multiple logistic regression and receiver operating characteristic curve analysis were obtained at the follow-up examination of participants in the two groups.
A total of 2,118 women were assigned to the GDM group (n = 639) and control group (n = 1,479). The mean level of serum GA in GDM group was significantly greater than that in the control group at both 24-28 and 36-38 weeks of gestation (P < 0.05). The area under the receiver operating characteristic curve for GA defining good glycemic control in GDM was 0.874 (95% confidence interval 0.811-0.938). The cut-off point for the GA levels derived from the receiver operating characteristic curve was 11.60%, which had sensitivity and specificity for detecting a poor glycemic status of 75.93% and 86.36%, respectively. The risk of birthweight ≥3,500 g and macrosomia increased significantly with GA levels ≥13.00% at 24-28 weeks and ≥12.00% at 36-38 weeks of gestation.
GA might be an appropriate and conveniently measured index that can detect poor glycemic control and predict birthweights in GDM women.
目的/引言:评估糖化白蛋白(GA)作为管理妊娠期糖尿病(GDM)潜在血糖指标的作用。
符合条件的孕妇分为口服75克葡萄糖耐量试验(OGTT)结果异常的GDM组和对照组(正常组)。在两组参与者的随访检查中进行GA测量、Pearson相关性分析、多元逻辑回归和受试者工作特征曲线分析。
共有2118名女性被分配到GDM组(n = 639)和对照组(n = 1479)。在妊娠24 - 28周和36 - 38周时,GDM组血清GA的平均水平均显著高于对照组(P < 0.05)。GA用于定义GDM良好血糖控制的受试者工作特征曲线下面积为0.874(95%置信区间0.811 - 0.938)。从受试者工作特征曲线得出的GA水平截断点为11.60%,其检测血糖状态不佳的敏感性和特异性分别为75.93%和86.36%。在妊娠24 - 28周时GA水平≥13.00%以及36 - 38周时≥12.00%时,出生体重≥3500克和巨大儿的风险显著增加。
GA可能是一个合适且便于测量的指标,可用于检测GDM女性的血糖控制不佳情况并预测出生体重。