糖化白蛋白在诊断妊娠糖尿病中的测试特征

Celestine Osita John, Atochi Prince Woruka, Kariba Akhidue, Rosemary Ogu
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摘要

本研究确定了糖化白蛋白在诊断妊娠糖尿病中的测试特性。诊断妊娠糖尿病的金标准是口服葡萄糖耐量试验,该试验需要患者做好准备、喝下葡萄糖溶液并采集多个样本。糖化白蛋白是诊断妊娠糖尿病的另一种可能的生物标志物,不需要患者做好准备,只需采集一份样本。美国黑人的糖化白蛋白水平高于白种人。这项研究涉及到在哈科特港大学教学医院产前门诊就诊的 200 名孕妇。妊娠糖尿病的诊断采用世界卫生组织 2013 年诊断标准。糖化白蛋白的检测特征采用接收者运算特征曲线下面积、灵敏度、特异性、阳性预测值和阴性预测值来确定。妊娠糖尿病的发病率为 9.0%。糖化白蛋白的接收者操作特征曲线下面积为 0.8(95% CI 0.7-0.9;P=0.0001)。糖化白蛋白的敏感性和特异性分别为 83.3% 和 86.8%。阳性预测值为 38.5%,阴性预测值为 98.1%。糖化白蛋白具有较高的灵敏度、特异性和阴性预测值,因此可用作妊娠糖尿病的初步检测。
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Test characteristics of glycated albumin in the diagnosis of gestational diabetes mellitus
This study determined the test characteristics of glycated albumin in the diagnosis of gestational diabetes mellitus. The gold standard for diagnosing gestational diabetes mellitus is the oral glucose tolerance test which requires patient preparation, drinking of glucose solution, and multiple sample collections. A possible alternative biomarker for the diagnosis of gestational diabetes is glycated albumin does not require patient preparation and only one sample is collected. Glycated albumin levels are higher among Black Americans than in Caucasians.The study involved 200 pregnant women attending the antenatal clinic at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was made using the World Health Organization 2013 diagnostic criteria. The test characteristics of glycated albumin were determined using the area under the curve of the receiver operator characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value. The prevalence of gestational diabetes mellitus was 9.0%. The area under the receiver operator characteristic curve for glycated albumin was 0.8 (95% CI 0.7-0.9; p=0.0001). The sensitivity and specificity of glycated albumin were 83.3% and 86.8% respectively. The positive predictive value was 38.5% and the negative predictive value was 98.1%. Glycated albumin has high sensitivity, specificity, and negative predictive values and therefore, can be used as a preliminary test for gestational diabetes mellitus.
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