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. 中华医学会妇产科学分会产科组. 妊娠合并糖尿病临床诊断与治疗推荐指南(草案). 中华妇产科杂志, 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. 余凤花, 罗宋, 陈妙岚, 等. 早孕期糖化血红蛋白检测在妊娠期糖尿病诊断中的应用. 中国实验诊断学, 2015, 19(6): 921-923.
17. 俞孝芳, 汪银芬. 糖化血红蛋白对妊娠糖尿病的筛查和诊断价值研究. 浙江预防医学, 2012, 24(7): 15-17.
18. 吕连峥, 蔺昕, 徐卫平, 等. HbA1c 在妊娠糖尿病诊断中的价值分析. 国际检验医学杂志, 2015, 36(1): 124-126.
19. 姜雪梅, 赵娟娟, 姚华, 等. HbA1c 检测在妊娠糖尿病筛查诊断中的价值. 新疆医科大学学报, 2014, 37(1): 70-73.
20. 廖辉荣. 糖化血红蛋白检测在妊娠期糖尿病中的辅助诊断价值. 医学信息, 2015, 28(5): 95-96.
21. 张业新, 王海军, 胡豪, 等. 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. 检验医学, 2014, 29(11): 1151-1153.
22. 张亚梅. 糖化血红蛋白监测在空腹血糖正常妊娠糖尿病孕妇中的应用价值. 大家健康(学术版), 2016, 10(7): 63-64.
23. 方先松, 温小云, 胡蓉. 糖化血红蛋白 A1c 在妊娠糖尿病筛查中的应用价值. 现代诊断与治疗, 2014, 25(21): 4896-4897.
24. 施雯君. 妊娠糖尿病患者糖化血红蛋白监测的临床意义. 实用临床医药杂志, 2014, 18(3): 111-112.
25. 曹玉君, 黄瑞梅, 张秀枝. 妊娠期糖尿病早期诊断指标的临床研究. 现代诊断与治疗, 2015, 26(14): 3217-3219.
26. 朱东林, 蒋韬, 马宁, 等. 妊娠糖尿病的筛查诊断指标分析. 医学临床研究, 2015, 32(9): 1819-1821.
27. 李玉翠. 糖化血红蛋白用于妊娠期糖尿病筛查的临床价值. 糖尿病新世界, 2014, 21(12): 29.
28. 李绮霞, 单青, 李文坚, 等. 糖化血红蛋白在妊娠期糖尿病孕妇中的检测价值. 中国妇幼健康研究, 2015, 12(3): 514-516.
29. 杨怡, 张捷. 评估 HbAlc 和 CRP 在妊娠期糖尿病筛查诊断中的临床价值. 中国妇幼保健, 2013, 28(11): 1729-1731.
30. 林晶, 陈宇清. 糖化血红蛋白在筛查妊娠期糖尿病中的价值. 中国妇幼健康研究, 2015, 21(2): 300-301.
31. 王亚南, 吴元健, 陆婵, 等. 糖化血红蛋白 A1c 在妊娠期糖尿病中的应用价值. 临床检验杂志, 2012, 30(6): 414-415.
32. 程晨, 张越, 何奖图, 等. 糖化血红蛋白及糖化白蛋白在妊娠期糖尿病诊断中的价值. 检验医学, 2014, 29(2): 135-138.
33. 肖维, 郑曦. 妊娠糖尿病监测糖化血清蛋白和糖化血红蛋白的意义. 现代诊断与治疗, 2015, 26(5): 961-962.
34. 胡俊. 糖化血红蛋白与果糖胺在妊娠糖尿病诊断中的临床应用. 当代医学, 2012, 18(3): 11-12.
35. 蔡慧华, 何援利, 王雪峰, 等. 糖化血红蛋白联合空腹血糖检测在妊娠期糖尿病筛查中的应用价值. 实用妇产科杂志, 2014, 30(3): 205-208.
36. 谢丽玲, 李妹燕, 吴惠珍, 等. 糖化血红蛋白对妊娠期糖尿病的诊断运用分析. 医学综述, 2013, 19(16): 3024-3026.
37. 谢龙. 妊娠期糖尿病血糖异常与糖化血红蛋白变化的临床意义. 亚太传统医药, 2012, 8(10): 2908-2909.
38. 贾建安. 糖化血红蛋白应用于妊娠期糖尿病早期筛查的价值探讨. 基层医学论坛, 2015, 19(3): 300-301.
39. 赵晓利, 孙利, 黄喜英. ROC 曲线评价糖化血红蛋白在妊娠期糖尿病诊断中价值探讨. 河北医学, 2016, 22(1): 99-102.
40. 邓湘. 妊娠糖尿病诊断筛查中糖化血红蛋白与糖化血清蛋白的应用价值探讨. 医学信息, 2015, 28(3): 108-109.
41. 陆胜, 季雄娟, 郑慧慧, 等. 糖化白蛋白检测在妊娠糖尿病中的价值. 浙江临床医学, 2016, 18(9): 1723-1725.
42. 陈友, 朱爱兰, 王怀. 糖化白蛋白及糖化血红蛋白在妊娠期糖尿病筛查中的价值. 医学理论与实践, 2015, 28(24): 3328-3329.
43. 陈旭华, 严妙娟, 罗锦彬. 糖化血红蛋白 HbA1c 在妊娠糖尿病诊断中的应用探讨. 齐齐哈尔医学院学报, 2015, 36(22): 3329-3330.
44. 陈晓玲, 梅浩砚, 刘恒辰, 等. 糖化血红蛋白在妊娠期糖尿病筛查中的应用价值. 中国卫生检验杂志, 2013, 23(13): 2781-2782.
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