糖化血红蛋白(HbAlc)在空腹血糖正常的妊娠糖尿病孕妇中的临床应用价值

Clinical Application Value of Glycosylated Hemoglobin(HbAlc) in Pregnant Women with Gestational Diabetes Mellitus with Normal Fasting Blood Glucose

目的 研究空腹血糖(FPG)正常的妊娠糖尿病(GDM)孕妇中糖化血红蛋白(HbA1c)的临床应用价值。方法 研究对象选取厦门大学附属第一医院于2016年6月—2021年6月收治的84例孕妇,其中中正常孕妇28名为A组,糖耐量受损孕妇28例为B组,妊娠糖尿病(空腹血糖正常)孕妇28例为C组,入组者均测定FPG、HbA1c水平,并行口服糖耐量实验(OGTT),对比3组FPG、HbA1c及OGTT试验结果,并对3组HbA1c阳性率进行比较。结果 与A组比较,B组HbA1c水平均更高,差异有统计学意义(P<0.05);与A组、B组比较,C组FPG、HbA1c水平均更高,差异有统计学意义(t=4.216、2.375、10.503、8.805,P<0.05);与A组比较,B组1hPG、2 hPG及3 hPG水平均更高,差异有统计学意义(t=10.837、4.944、16.002,P<0.05);与A组、B组比较,C组1 hPG、2 hPG及3 hPG水平均更高,差异有统计学意义(t=13.183、5.772、10.605、7.782、32.009、7.616,P<0.05);与A组、B组比较,C组HbA1c阳性率均更高,差异有统计学意义(χ~2=41.195、27.026,P<0.05)。结论 HbA1c可作为FPG正常的GDM孕妇的一个重要筛查指标,可准确诊断GDM,为临床诊治提供指导。

Objective To study the clinical value of glycated hemoglobin(HbA1c) in pregnant women with gestational diabetes mellitus(GDM) with normal fasting blood glucose(FPG).Methods A total of 84 pregnant women who were admitted to the First Affiliated Hospital of Xiamen University from June 2016 to June 2021 were selected as the research subjects.Among them,28 normal pregnant women belonged to group A.Twenty-eight pregnant women with impaired glucose tolerance were in group B,and 28 pregnant women with gestational diabetes mellitus(normal fasting blood glucose) were in group C.The levels of FPG and HbA1c were measured in all participants,and oral glucose tolerance test(OGTT) was performed.The results of FPG,HbA1c and OGTT tests in the three groups were compared,and the positive rates of HbA1c in the three groups were compared.Results Compared with group A,the level of HbA1c in group B was higher,and the difference was statistically significant(P<0.05).Compared with groups A and B,the levels of FPG and HbA1c in group C were higher,and the difference was statistically significant(t=4.216,2.375,10.503,8.805,P<0.05).Compared with group A,the levels of 1 hPG,2 hPG and 3 hPG in group B were higher,and the difference was statistically significant(t=10.837,4.944,16.002,P<0.05).Compared with groups A and B,the levels of 1 hPG,2 hPG and 3 hPG in group C were higher,and the difference was statistically significant(t=13.183,5.772,10.605,7.782,32.009,7.616,P<0.05).Compared with group A and group B,the positive rate of HbA1c in group C was higher,and the difference was statistically significant(χ~2=41.195,27.026,P<0.05).Conclusion HbA1c can be used as an important screening index for GDM pregnant women with normal FPG,which can accurately diagnose GDM and provide guidance for clinical diagnosis and treatment.