Application and evaluation of significance of glycosylated hemoglobin test in gestational diabetes mellitus screening

Objective:To investigate the contribution and value of glycosylated hemoglobin(HbAlc)test in the screening of gestational diabetes mellitus.Methods:The fasting blood sugar,oral glucose screen and HbA1c were measured in 318 of normal gestation women group,60 of impaired glucose tolerance group and 105 of gestational diabetes mellitus group.The evaluation of significance of FPG,OGCT and HbAlc in GDM Screening were evaluated using the receiver-operating characteristic(ROC) curves.Results:The levels of FPG,OGCT and HbAlc were significantly higher than those in normal gestation group and impaired glucose tolerance group(P0.05).The positive rate of HbAlc in normal gestation women group,impaired glucose tolerance group and gestational diabetes mellitus group were 2.2%,43.5% and 82.9%,respectively.The positive rate of gestational diabetes mellitus group was obviously higher than those in normal gestation group and impaired glucose tolerance group(P 0.05).The sensitivity,specificity,dependability and predicting positively of HbAlc test in screening gestational diabetes mellitus were 82.9%,97.8%,94.1%,and 92.6%,respectively.The area under the curve(AUC) of FPG,OGCT and HbAlc was 83.5%,91.8% and 0.6%,respectively.for GDM diagnosis,and with the optimal cut-off value of 7.8 mmol/L,OCGT showed a diagnostic sensitivity of 68.6% and spectificity of 96.5%;and the optimal cut-off value of 6.0%,HbAlc showed a diagnostic sensitivity of 82.9% and spectificity of 97.8%.Conculsion:HbAlc can be served as an index for gestational diabetes mellitus screening and diagnoses.