Paleari Renata, Vidali Matteo, Ceriotti Ferruccio, Pintaudi Basilio, Luisa De Angelis Maria, Vitacolonna Ester, Cataldo Ivana, Torlone Elisabetta, Succurro Elena, Angotti Elvira, Alessi Eugenio, Mosca Andrea
Dip. di Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, Milano, Italy; CIRME, Università degli Studi di Milano, Milano, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, SC Patologia Clinica, Milano, Italy.
Clin Chim Acta. 2023 Feb 15;541:117246. doi: 10.1016/j.cca.2023.117246. Epub 2023 Feb 6.
Glycated albumin (GA) may assess glycometabolic control over a short period of time respect to HbA, and its use to screen for gestational diabetes in pregnancy has been suggested. To this regard few data on reference intervals (RI) for GA on Europid women have been collected, only from cross-sectional investigations. Aim of this work has been to collect trimester-specific RI for GA in physiological pregnancies, following a longitudinal prospective study.
Forty-five healthy pregnant Europid women have been enrolled for whom a GDM screening test was scheduled at 24-28 weeks, in 5 different Italian centers. Only those negative to the OGTT were included. The women had 4 successive visits at 6-10 weeks of gestation, at 16-18 weeks, at 24-28 weeks and at the end of pregnancy. ALT, AST, total bilirubin, C-reactive protein, cholinesterase, creatinine, GGT, glycated albumin, iron, total serum proteins, transferrin were measured in duplicate on aliquots of serum samples by a central laboratory.
The RI (2.5-97.5 percentiles) for GA were 11.1-14.8 % (I visit), 10.9-15.6 % (II visit), 10.6-14.1 % (III visit) and 10.7-14.3 % (IV visit). The RI of other biomarkers confirmed previously published data. The RI for serum cholinesterase we present are novel, and were 5049-9906 U/L (Iv), 4212-8965 U/L (IIv), 3518-8470 U/L (IIIv) and 3945-8727 U/L (IVv).
Trimester-specific RI are important for using GA and serum cholinesterase in pregnancy. However, considering the high inter-individual variability of both markers, the use of longitudinal interpretations of the individual variations of both proteins during pregnancy should be preferred.
相较于糖化血红蛋白（HbA），糖化白蛋白（GA）或许能在短时间内评估糖代谢控制情况，并且有人提出用其筛查妊娠期糖尿病。关于欧洲女性GA的参考区间（RI），目前仅通过横断面调查收集到了少量数据。本研究旨在通过纵向前瞻性研究，收集生理妊娠各孕期GA的特异性RI。
在意大利5个不同中心，招募了45名计划在孕24 - 28周进行妊娠期糖尿病筛查试验的健康欧洲孕妇。仅纳入口服葡萄糖耐量试验（OGTT）结果为阴性的孕妇。这些孕妇在妊娠6 - 10周、16 - 18周、24 - 28周及妊娠末期进行了4次连续随访。中心实验室对血清样本等分试样中的丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素、C反应蛋白、胆碱酯酶、肌酐、γ-谷氨酰转移酶、糖化白蛋白、铁、总血清蛋白、转铁蛋白进行了双份测定。
GA的RI（第2.5 - 97.5百分位数）分别为11.1 - 14.8%（第一次随访）、10.9 - 15.6%（第二次随访）、10.6 - 14.1%（第三次随访）和10.7 - 14.3%（第四次随访）。其他生物标志物的RI证实了先前发表的数据。我们给出的血清胆碱酯酶的RI是新的数据，分别为（第一次随访）5049 - 9906 U/L、（第二次随访）4212 - 8965 U/L、（第三次随访）3518 - 8470 U/L和（第四次随访）3945 - 8727 U/L。
孕期特异性RI对于孕期使用GA和血清胆碱酯酶很重要。然而，考虑到这两种标志物个体间差异较大，孕期应优先采用对这两种蛋白质个体变化进行纵向解读的方法。
