Can Glycosylated Hemoglobin and Fasting Blood Sugar Replace Glucose Challenge Test in Screening for Gestational Diabetes?

Pub Date : 2023-06-11 DOI:10.15296/ijwhr.2023.23
S. Dehghan, Farima Mohammadianamiri, S. Yazdani, H. Musavi, Seyed Zahra Bouzari, Samira Mesbah, M. Bayani, Mohammad Abedi Samakoush, Z. Bouzari, E. Ebrahim
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Abstract

Objectives: The present study aimed to compare the diagnostic values of glycosylated hemoglobin (HbA1c) and fasting blood sugar (FBS) using the glucose challenge test (GCT) in screening for gestational diabetes. Materials and Methods: A total of 618 women at 24-28 weeks of pregnancy were selected, and their FBS and HbA1c were measured using the GCT. The obtained results were compared in terms of sensitivity, specificity, as well as positive and negative predictive values using the ROC curve. Results: At the cut-off point of 1.4, sensitivity was 69.74% and specificity was 69.05 for the FBS test; at the cut-off point of 6.6, sensitivity was 90.79% and specificity was 80.95% for the HbA1c test; the area under the ROC curve was 0.925 with a 95% confidence interval (0.979, 0.872). Conclusion: The diagnostic values of the HbA1c test and GCT were favorable in screening for gestational diabetes; the HbA1c test also showed a high diagnostic value in women with positive OGCT and GCT results.
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糖化血红蛋白和空腹血糖能代替葡萄糖激发试验筛查妊娠糖尿病吗?
目的:本研究旨在比较葡萄糖激发试验(GCT)中糖化血红蛋白(HbA1c)和空腹血糖(FBS)在筛查妊娠糖尿病中的诊断价值。材料与方法:选择618例妊娠24-28周的妇女,使用GCT测量她们的FBS和HbA1c。使用ROC曲线比较所得结果的敏感性、特异性以及阳性预测值和阴性预测值。结果:在分界点1.4时,FBS检测的敏感性为69.74%,特异性为69.05;分界点为6.6时,HbA1c检测的敏感性为90.79%,特异性为80.95%;ROC曲线下面积为0.925,95%可信区间(0.979,0.872)。结论:HbA1c检测和GCT对妊娠期糖尿病的筛查具有良好的诊断价值;在OGCT和GCT阳性的女性中,HbA1c检测也显示出很高的诊断价值。
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