糖化血红蛋白联合空腹血糖在早期妊娠期糖尿病筛查中的应用价值

Application value of glycated hemoglobin combined with fasting blood glucose in the screening of early gestational diabetes mellitus

目的探讨糖化血红蛋白(HbA1c)联合空腹血糖(FPG)在早期妊娠期糖尿病(GDM)筛查中的应用价值。方法选取2017年1月~2018年7月我院妇产科确诊的64例GDM患者作为GDM组,另选取同期来我院行常规产检的64例健康孕妇作为对照组。两组均行HbA1c及口服葡萄糖耐量试验(OGTT)检测。比较两组受试者FPG、HbA1c和服糖后不同时间的OGTT水平;比较不同指标检测的曲线下面积(AUC)、灵敏度、特异性及准确率。结果GDM组的FPG、HbA1c及服糖后1、2 h OGTT水平均高于对照组,差异有统计学意义(P<0.05);FPG与HbA1c联合检测诊断GDM的受试者工作特征(ROC)AUC高于二者单独检测,差异有统计学意义(P<0.05);FPG与HbA1c联合检测诊断GDM的灵敏度、特异性及准确率均高于二者单独检测,差异有统计学意义(P<0.05)。结论HbA1c与FPG两项指标联合应用于诊断GDM具有更高的诊断效能,对GDM患者的早期筛查具有指导意义。

Objective To explore the application value of glycated hemoglobin(HbA1c)combined with fasting blood glucose(FPG)in the screening of early gestational diabetes mellitus(GDM).Methods A total of 64 patients with GDM diagnosed in the obstetrics and gynecology department of our hospital from January 2017 to July 2018 were selected as the GDM group,and 64 healthy pregnant women who underwent routine birth examination in our hospital during the same period were selected as the control group.Both groups were tested for HbA1c and oral glucose tolerance test(OGTT).FPG,HbA1c and OGTT were compared between the two groups.The area under curve(AUC),sensitivity,specificity and accuracy of different indexes were compared.Results The levels of FPG,HbA1c and OGTT in the GDM group at 1 and 2 hours after taking glucose were higher than those in the control group,the differences were statistically significant(P<0.05).The receiver operating characteristic(ROC)AUC of subjects with combined detection of FPG and HbA1c in the diagnosis of GDM were higher than those of the two alone,the differences were statistically significant(P<0.05).The sensitivity,specificity and accuracy of the combined detection of FPG and HbA1c in the diagnosis of GDM were higher than those of the two alone,the differences were statistically significant(P<0.05).Conclusion The combined use of HbA1c and FPG in the diagnosis of GDM has higher diagnostic efficacy,and has guiding significance for early screening of patients with GDM.