Puavilai G, Chanprasertyotin S, Jirapinyo M
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1993 Oct;76(10):549-53.
To assess the potential value of glycosylated hemoglobin measurement (HbA1) in screening for gestational diabetes mellitus (GDM), HbA1 by a colorimetric method, plasma glucose level 1 hr after 50 g oral glucose loading, and 3-hr 100 g oral glucose tolerance test (3-hr OGTT) were performed in 334 pregnant women at Ramathibodi Hospital. These subjects carried high risk factors of GDM. Gestational ages varied from 24 to 38 wks. Twenty-four cases were diabetic (7.2%) by O'Sullivan and Mahan's criteria (1964). As a screening test to select subjects for 3-hr OGTT, plasma glucose level 1 hr after 50 g oral glucose load (plasma glucose level 7.8 mmol/L and above) has sensitivity: 87.50 per cent, specificity: 64.19 per cent. HbA1 level of 5.60 per cent (upper 95% confidence limit of the mean) and above yield sensitivity: 66.67 per cent, specificity: 61.29 per cent. Thus, glycosylated hemoglobin measurement as a screening test for GDM is not as effective as the conventional 50 g oral glucose loading test.
为评估糖化血红蛋白测量（HbA1）在筛查妊娠期糖尿病（GDM）中的潜在价值，对拉玛蒂博迪医院的334名孕妇进行了比色法HbA1测定、50克口服葡萄糖负荷后1小时的血浆葡萄糖水平测定以及3小时100克口服葡萄糖耐量试验（3小时OGTT）。这些受试者具有GDM的高危因素。孕周从24周到38周不等。根据奥沙利文和马汉（1964年）的标准，有24例为糖尿病患者（7.2%）。作为选择进行3小时OGTT受试者的筛查试验，50克口服葡萄糖负荷后1小时的血浆葡萄糖水平（血浆葡萄糖水平7.8 mmol/L及以上）的敏感性为87.50%，特异性为64.19%。HbA1水平达到5.60%（均值的95%置信上限）及以上时，敏感性为66.67%，特异性为61.29%。因此，糖化血红蛋白测量作为GDM的筛查试验不如传统的50克口服葡萄糖负荷试验有效。
