Morris M A, Grandis A S, Litton J
Obstet Gynecol. 1986 Sep;68(3):357-61. doi: 10.1097/00006250-198609000-00013.
Previous studies suggested that the assessment of hemoglobin A1 (HbA1) concentration was a poor indicator of diabetes in pregnancy. However, HbA1 was measured by ion exchange chromatography, which is subject to spurious alterations. To reevaluate the use of glycosylated hemoglobin concentration (GlyHb) as an indicator of gestational diabetes, 64 women at 10 to 15 weeks' gestation were studied by measuring GlyHb by a specific affinity chromatography assay, and blood glucose concentration was determined one hour post a 50-g oral glucose load. Gestational diabetes developed in 15 women in whom GlyHb (7.4 +/- 0.2%) was greater than in normal pregnant women (5.7 +/- 0.1%, P less than .001). If a GlyHb of 6.3% were chosen as the threshold for diagnostic evaluation for diabetes, only 6.7% of the gestational diabetics would have missed diagnosis. Of normal women, 14.2% would have been subjected to glucose tolerance test. GlyHb elevation was associated with the birth of infants large for gestational age. The assessment of GlyHb by affinity chromatography between 10 and 15 weeks' gestation may be a sensitive predictor of patients who will develop gestational diabetes.
以往的研究表明，血红蛋白A1（HbA1）浓度的测定对妊娠期糖尿病而言是一个欠佳的指标。然而，HbA1是通过离子交换色谱法测定的，该方法容易出现假性改变。为了重新评估糖化血红蛋白浓度（GlyHb）作为妊娠期糖尿病指标的用途，对64名妊娠10至15周的女性进行了研究，采用特异性亲和色谱分析法测定GlyHb，并在口服50克葡萄糖负荷后1小时测定血糖浓度。15名女性发生了妊娠期糖尿病，她们的GlyHb（7.4±0.2%）高于正常孕妇（5.7±0.1%，P<0.001）。如果选择6.3%的GlyHb作为糖尿病诊断评估的阈值，只有6.7%的妊娠期糖尿病患者会漏诊。在正常女性中，14.2%会接受葡萄糖耐量试验。GlyHb升高与大于胎龄儿的出生有关。在妊娠10至15周期间通过亲和色谱法评估GlyHb可能是预测妊娠期糖尿病患者的一个敏感指标。
