糖化血红蛋白及糖化白蛋白在妊娠期糖尿病初筛中的价值

目的探讨糖化白蛋白(GA)和糖化血红蛋白(Hb A1c)检测在妊娠期糖尿病(GDM)筛查中的价值。方法选取妊娠22~28周的孕妇289例,其中血糖正常组202例、GDM组87例。分别采用己糖激酶法检测血糖、高压液相层析法检测Hb A1c,酶法检测GA。结果 GDM组Hb A1c为(5.20%±0.09%),明显高于血糖正常组(5.03%±0.02%,P0.01);GA为13.48%±0.28%,与血糖正常组(13.39%±0.09%)比较差异无统计学意义(P0.05)。Pearson相关分析显示血糖与Hb A1c呈正相关(r=0.203,P0.01),血糖与GA无相关性(r=0.114,P0.05),Hb A1c与GA无相关性(r=0.041,P0.05)。以血糖正常组Hb A1c第95%位值(5.50%)作为判断依据筛查GDM,特异性为94.55%,敏感性为86.21%。结论 Hb A1c相对于GA而言,是筛查GDM更好的指标。

Significance of HbA1c and GA in initial screening of gestational diabetes mellitus

Objective To investigate the significance of glycated albumin（GA）and glycosylated hemoglobin A1 c （HbA1 c ）in screening gestational diabetes mellitus（GDM）.Methods There were 289 women with pregnancy for 22-28 weeks.A total of 202 cases were enrolled in normal blood glucose group,and 87 cases were enrolled in GDM group. Hexokinase method was used to detect glucose,and high pressure liquid chromatography was used to detect HbA1 c ,and enzyme method was used to detect GA.Results HbA1 c of GDM group was 5.20% ＆#177;0.09%,which was significantly higher than that of normal blood glucose group （5.03% ＆#177;0.02%,P ＆lt;0.01 ）.GA of GDM group was 1 3.48% ＆#177; 0.28%,that of normal blood glucose group was 1 3.39% ＆#177;0.09%,and the difference had no statistical significance （P＆gt;0.05）.Pearson correlation analysis showed that glucose was positively correlated with HbA1 c （r =0.203,P ＆lt;0.01 ）, and there was no correlation between glucose and GA （r =0.1 1 4,P ＆gt;0.05）.There was no correlation between HbA1 c and GA （r =0.041 ,P ＆gt;0.05）.Using HbA1 c 95% value （5.50%）in normal blood glucose group as the judgment basis for screening GDM,the specificity was 94.55%,and the sensitivity was 86.21 %.Conclusions HbA1 c ,other than GA,is a good indicator for screening GDMinitially.