Diagnostic value of glycosylated hemoglobin in gestational diabetes mellitus in Chinese: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

Narenqimuge ,  LI Dongmei , LIANG Hongwei , MI Linxiang

Department of Endocrinology Inner Mongolia Autonomous Region People’s Hospital, Hohhot, 010010, P.R.China;

Corresponding?author：

LI Dongmei, Email: ldm1229@126.com

Keywords：

HbA1c; OGTT; GDM; Diagnosis; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.201701103

Video：

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ObjectiveTo systematically review the diagnosis value of glycosylated hemoglobin (HbA1c) in diagnosis of gestational diabetes mellitus (GDM).MethodsThe diagnostic studies concerning glycosylated hemoglobin in gestational diabetes were electronically searched in EMbase, PubMed, The Cochrane Library, CNKI, WanFang Data and VIP from inception to October, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by RevMan 5.3 and Meta-Disc 1.4 software.ResultsA total of 33 studies involving 16 622 persons were included. The results of meta-analysis showed that the pooled sensitivity, specificity, positive predictive value, negative predictive value, the pooled DOR of HbA1c were 0.75 (95%CI 0.74 to 0.77), 0.91 (95%CI 0.90 to 0.91), 8.21 (95%CI 5.41 to 12.46), 0.18 (95%CI 0.11 to 0.28), 45.10 (95%CI 29.70 to 68.48), respectively. The AUC of SROC was 0.933 5. Subgroup analysis by different HbA1c measurements indicated that little variations between different measurements in sensitivity and specificity.ConclusionHbA1c in GDM diagnosis has high sensitivity and specificity. Due to the limited quality and quantity of included studies, the above results should be validated by more studies.

Citation： Narenqimuge, LI Dongmei, LIANG Hongwei, MI Linxiang. Diagnostic value of glycosylated hemoglobin in gestational diabetes mellitus in Chinese: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(7): 774-782. doi: 10.7507/1672-2531.201701103 Copy

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1. Executive summary: standards of medical care in diabetes-2010. Diabetes Care, 2010, 33(Suppl 1): 4-10.
2. Pedula KL, Hillier TA, Schmidt MM, et al. Ethnic differences in gestational oral glucose screening in a large US population. Ethn Dis, 2009, 19(4): 414-419.
3. Hadar E, Oats J, Hod M. Towards new diagnostic criteria for diagnosing GDM: the HAPO study. J Perinat Med, 2009, 37(5): 447-449.
4. 中華醫學會婦產科學分會產科組. 妊娠合并糖尿病臨床診斷與治療推薦指南(草案). 中華婦產科雜志, 2007, 23(6): 475-477.
5. Weinert LS. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: comment to the international association of diabetes and pregnancy study groups consensus panel. Diabetes Care, 2010, 33(7): 97-98.
6. Metzger BE, Gabbe SG, Persson B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care, 2010, 33(3): 676-682.
7. Herman WH, Kalyani RR, Wexler DJ, et al. Response to comment on American Diabetes Association. Diabetes Care, 2016, 39(6): 88-89.
8. Milan K, Branch DW, Porter TF, et al. 262: Glycated albumin and hemoglobin A1c: an alternate screen for first trimester gestational diabetes. Am J Obstet Gynecol, 2012, 206(1): 128-129.
9. Aldasouqi SA, Solomon DJ, Bokhari SA, et al. Glycohemoglobin A1c: A promising screening tool in gestational diabetes mellitus. Int J Diabetes Dev Ctries, 2008, 28(4): 121-124.
10. Anthony AF, Ann SH, Christopher D, et al. Association of British Clinical Diabetologists Autumn Meeting 2011 Abstracts. Practical Diabetes, 2012, 29(3): 124a-124e.
11. Moore L, Clokey D. 263: Patients with HgbA1c between 5.7%-6.4% at the first prenatal visit are 30 times more likely to develop GDM. Am J Obstet Gynecol, 2012, 206(1): 129.
12. Balaji V, Madhuri BS, Ashalatha S, et al. A1c in gestational diabetes mellitus in Asian Indian women. Diabetes Care, 2007, 30(7): 1865-1867.
13. Rajput R, Rajput M, Nanda S. Utility of HbA1c for diagnosis of gestational diabetes mellitus. Diabetes Res Clin Pract, 2012, 98(1): 104-107.
14. Tian QW, Xuan C, Wang HW, et al. Diagnostic accuracy of glycosylated hemoglobin in Chinese patients with gestational diabetes mellitus: a meta-analysis based on 2 812 patients and 5 918 controls. Genet Test Mol Biomarkers, 2013, 17(9): 687-695.
15. Ye M, Liu Y, Cao X, et al. The utility of HbA1c for screening gestational diabetes mellitus and its relationship with adverse pregnancy outcomes. Diabetes Res Clin Pract, 2016, 4(114): 43-49.
16. 余鳳花, 羅宋, 陳妙嵐, 等. 早孕期糖化血紅蛋白檢測在妊娠期糖尿病診斷中的應用. 中國實驗診斷學, 2015, 19(6): 921-923.
17. 俞孝芳, 汪銀芬. 糖化血紅蛋白對妊娠糖尿病的篩查和診斷價值研究. 浙江預防醫學, 2012, 24(7): 15-17.
18. 呂連崢, 藺昕, 徐衛平, 等. HbA1c 在妊娠糖尿病診斷中的價值分析. 國際檢驗醫學雜志, 2015, 36(1): 124-126.
19. 姜雪梅, 趙娟娟, 姚華, 等. HbA1c 檢測在妊娠糖尿病篩查診斷中的價值. 新疆醫科大學學報, 2014, 37(1): 70-73.
20. 廖輝榮. 糖化血紅蛋白檢測在妊娠期糖尿病中的輔助診斷價值. 醫學信息, 2015, 28(5): 95-96.
21. 張業新, 王海軍, 胡豪, 等. 糖化血紅蛋白及糖化白蛋白在妊娠期糖尿病初篩中的價值. 檢驗醫學, 2014, 29(11): 1151-1153.
22. 張亞梅. 糖化血紅蛋白監測在空腹血糖正常妊娠糖尿病孕婦中的應用價值. 大家健康(學術版), 2016, 10(7): 63-64.
23. 方先松, 溫小云, 胡蓉. 糖化血紅蛋白 A1c 在妊娠糖尿病篩查中的應用價值. 現代診斷與治療, 2014, 25(21): 4896-4897.
24. 施雯君. 妊娠糖尿病患者糖化血紅蛋白監測的臨床意義. 實用臨床醫藥雜志, 2014, 18(3): 111-112.
25. 曹玉君, 黃瑞梅, 張秀枝. 妊娠期糖尿病早期診斷指標的臨床研究. 現代診斷與治療, 2015, 26(14): 3217-3219.
26. 朱東林, 蔣韜, 馬寧, 等. 妊娠糖尿病的篩查診斷指標分析. 醫學臨床研究, 2015, 32(9): 1819-1821.
27. 李玉翠. 糖化血紅蛋白用于妊娠期糖尿病篩查的臨床價值. 糖尿病新世界, 2014, 21(12): 29.
28. 李綺霞, 單青, 李文堅, 等. 糖化血紅蛋白在妊娠期糖尿病孕婦中的檢測價值. 中國婦幼健康研究, 2015, 12(3): 514-516.
29. 楊怡, 張捷. 評估 HbAlc 和 CRP 在妊娠期糖尿病篩查診斷中的臨床價值. 中國婦幼保健, 2013, 28(11): 1729-1731.
30. 林晶, 陳宇清. 糖化血紅蛋白在篩查妊娠期糖尿病中的價值. 中國婦幼健康研究, 2015, 21(2): 300-301.
31. 王亞南, 吳元健, 陸嬋, 等. 糖化血紅蛋白 A1c 在妊娠期糖尿病中的應用價值. 臨床檢驗雜志, 2012, 30(6): 414-415.
32. 程晨, 張越, 何獎圖, 等. 糖化血紅蛋白及糖化白蛋白在妊娠期糖尿病診斷中的價值. 檢驗醫學, 2014, 29(2): 135-138.
33. 肖維, 鄭曦. 妊娠糖尿病監測糖化血清蛋白和糖化血紅蛋白的意義. 現代診斷與治療, 2015, 26(5): 961-962.
34. 胡俊. 糖化血紅蛋白與果糖胺在妊娠糖尿病診斷中的臨床應用. 當代醫學, 2012, 18(3): 11-12.
35. 蔡慧華, 何援利, 王雪峰, 等. 糖化血紅蛋白聯合空腹血糖檢測在妊娠期糖尿病篩查中的應用價值. 實用婦產科雜志, 2014, 30(3): 205-208.
36. 謝麗玲, 李妹燕, 吳惠珍, 等. 糖化血紅蛋白對妊娠期糖尿病的診斷運用分析. 醫學綜述, 2013, 19(16): 3024-3026.
37. 謝龍. 妊娠期糖尿病血糖異常與糖化血紅蛋白變化的臨床意義. 亞太傳統醫藥, 2012, 8(10): 2908-2909.
38. 賈建安. 糖化血紅蛋白應用于妊娠期糖尿病早期篩查的價值探討. 基層醫學論壇, 2015, 19(3): 300-301.
39. 趙曉利, 孫利, 黃喜英. ROC 曲線評價糖化血紅蛋白在妊娠期糖尿病診斷中價值探討. 河北醫學, 2016, 22(1): 99-102.
40. 鄧湘. 妊娠糖尿病診斷篩查中糖化血紅蛋白與糖化血清蛋白的應用價值探討. 醫學信息, 2015, 28(3): 108-109.
41. 陸勝, 季雄娟, 鄭慧慧, 等. 糖化白蛋白檢測在妊娠糖尿病中的價值. 浙江臨床醫學, 2016, 18(9): 1723-1725.
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