HBA1c values of detection in the diagnosis of gestational diabetes screening

Objective To study the value of the glycosylated hemoglobin(HBA1c)in the diagnosis of gestational diabetes mellitus(GDM),to provide the reference for clinical application of HBA1c.Methods 541cases of pregnants between 24to 28 weeks were selected between January 2012and June 2013in Maternity hospital maternity and children′s health care centers of Xinjiang uygur autonomous region of Urumqi.We tested the fasting plasma glucose(FPG),75g oral glucose tolerance test(OGTT) and HBA1cfor them.Based on the latest GDM diagnosis standard of American Diabetes association(ADA),the samples were divided into the GDM group(267cases)and the control group(274cases), evaluating the diagnosis value of FPG,HBA1cin GDM by the receiver-operating characteristic(ROC); Ensuring preliminary the tangent point for GDM by screening HBA1c;evaluating the FPG and HBA1c, and comparing the efficiency of diagnostic.Results The AUC of HBA1C,fasting plasma glucose(FPG) were 0.901,0.819,which turned out to be a high accuracy.The detection sensitivity(94.4%)of HBAIc was significantly higher than those of FPG(61.0%),and HBA1cmissed diagnosis rate was 5.6%,far below the FPG of missed diagnosis(39.0%),which approved that HBA1cwas more suitable for screening for GDM than FPG.Take HBA1c5.45%as the boundary value of the screening is more suitable.Conclusion AUC of GDM which was higher than 0.9turned out to be a great accuracy.Taking 5.45% as the cut-off value was more appropriate,the diagnosis efficiency was higher,which had certain clinical value in screening for GDM.HBA1cscreening for GDM could be taken as a standard for GDM compared with missed diagnosis FPD.