Xiong Wei, Zeng Zhao-Hui, Xu Yuan, Li Hui, Lin Hui
Department of Medical, Hunan Traditional Chinese Medical College, Zhuzhou 412012, Hunan Province, China.
Department of Outpatient, Zhuzhou Second Hospital, Zhuzhou 412012, Hunan Province, China.
World J Diabetes. 2024 Aug 15;15(8):1802-1810. doi: 10.4239/wjd.v15.i8.1802.
Gestational diabetes mellitus (GDM) is characterized by glucose intolerance that is first diagnosed during pregnancy, making it the most common complication associated with this period. Early detection and targeted treatment of GDM can minimize foetal exposure to maternal hyperglycaemia and subsequently reduce the associated adverse pregnancy outcomes. Previous studies have inconsistently suggested that the level of glycated albumin (GA) might predict GDM.
To review and synthesize existing evidence to evaluate the relationship between GA levels and the development of GDM.
We sought to compare GA levels between GDM and control groups in this meta-analysis by systematically searching the Web of Science, PubMed, Cochrane Library, and Embase databases for articles published up to June 2023. The analysis utilized the weighted mean difference (WMD) as the primary metric. The data were meticulously extracted, and the quality of the included studies was assessed. Additionally, we conducted a subgroup analysis based on study region and sample size. We assessed heterogeneity using statistics and evaluated publication bias through funnel plots. Additionally, trim-and-fill analysis was employed to detect and address any potential publication bias.
The meta-analysis included a total of 11 studies involving 5477 participants, comprising 1900 patients with GDM and 3577 control individuals. The synthesized results revealed a notable correlation between elevated GA levels and increased susceptibility to GDM. The calculated WMD was 0.42, with a 95% confidence interval (95%CI) ranging from 0.11 to 0.74, yielding a value less than 0.001. Concerning specific GA levels, the mean GA level in the GDM group was 12.6, while for the control group, it was lower, at 11.6. This discrepancy underscores the potential of GA as a biomarker for assessing GDM risk. Moreover, we explored the levels of glycated haemoglobin (HbA1c) in both cohorts. The WMD for HbA1c was 0.19, with a 95%CI ranging from 0.15 to 0.22 and a value less than 0.001. This observation suggested that both GA and HbA1c levels were elevated in individuals in the GDM group compared to those in the control group.
Our meta-analysis revealed a substantial correlation between elevated GA levels and increased GDM risk. Furthermore, our findings revealed elevated levels of HbA1c in GDM patients, emphasizing the significance of monitoring both GA and HbA1c levels for early GDM detection and effective management.
妊娠期糖尿病（GDM）的特征是在孕期首次诊断出的葡萄糖不耐受，这使其成为与该时期相关的最常见并发症。早期检测和针对性治疗妊娠期糖尿病可最大程度减少胎儿暴露于母体高血糖环境中，并进而降低相关的不良妊娠结局。既往研究对糖化白蛋白（GA）水平是否可预测妊娠期糖尿病的结果并不一致。
回顾并综合现有证据，以评估GA水平与妊娠期糖尿病发生之间的关系。
在这项荟萃分析中，我们通过系统检索科学网、PubMed、Cochrane图书馆和Embase数据库，查找截至2023年6月发表的文章，试图比较妊娠期糖尿病组与对照组之间的GA水平。分析采用加权平均差（WMD）作为主要指标。数据被精心提取，并对纳入研究的质量进行评估。此外，我们根据研究地区和样本量进行了亚组分析。我们使用I²统计量评估异质性，并通过漏斗图评估发表偏倚。此外，采用剪补法分析来检测和解决任何潜在的发表偏倚。
该荟萃分析共纳入11项研究，涉及5477名参与者，其中包括1900例妊娠期糖尿病患者和3577名对照个体。综合结果显示，GA水平升高与患妊娠期糖尿病的易感性增加之间存在显著相关性。计算得出的WMD为0.42，95%置信区间（95%CI）为0.11至0.74，P值小于0.001。关于特定的GA水平，妊娠期糖尿病组的平均GA水平为12.6，而对照组较低，为11.6。这种差异凸显了GA作为评估妊娠期糖尿病风险生物标志物的潜力。此外，我们还探究了两组人群的糖化血红蛋白（HbA1c）水平。HbA1c的WMD为0.19，95%CI为0.15至0.22，P值小于0.001。这一观察结果表明，与对照组相比，妊娠期糖尿病组个体的GA和HbA1c水平均升高。
我们的荟萃分析显示，GA水平升高与妊娠期糖尿病风险增加之间存在显著相关性。此外，我们的研究结果显示妊娠期糖尿病患者的HbA1c水平升高，强调了监测GA和HbA1c水平对于早期检测妊娠期糖尿病和有效管理的重要性。
