Cargando…

The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus

Objective: Gestational diabetes mellitus (GDM) is a prevalent disorder which increases maternal and fetal complications. The oral glucose tolerance test (OGTT) is a traditional, time -consuming and intensive test which is poorly tolerated by pregnant women. To date, increasing evidence considered Hb...

Descripción completa

Detalles Bibliográficos
Autores principales: Mousavi, Seyedeh Neda, Kamali, Koorosh, Mirbazel, Motahareh, Jameshorani, Maryam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664988/
https://www.ncbi.nlm.nih.gov/pubmed/29114267
_version_ 1783275098929627136
author Mousavi, Seyedeh Neda
Kamali, Koorosh
Mirbazel, Motahareh
Jameshorani, Maryam
author_facet Mousavi, Seyedeh Neda
Kamali, Koorosh
Mirbazel, Motahareh
Jameshorani, Maryam
author_sort Mousavi, Seyedeh Neda
collection PubMed
description Objective: Gestational diabetes mellitus (GDM) is a prevalent disorder which increases maternal and fetal complications. The oral glucose tolerance test (OGTT) is a traditional, time -consuming and intensive test which is poorly tolerated by pregnant women. To date, increasing evidence considered HbA1c as a screening tool and reported various cut-off values in different populations. In alignment with existing literature, we determined for the first time, the optimal cut-off value for HbA1c in Iranian women with GDM. Materials and methods: This case-control study was conducted in Valie-Asr hospital between June 2015 and March 2016. A total of 200 pregnant women who were diagnosed with GDM were selected as study cases. For the control group, 200 healthy women were randomly selected. Fasting blood samples were taken for biochemical analysis, and OGTT was done in all participants. Demographic and anthropometric indexes were measured. Performance of the HbA1c test was analyzed by the Receiver Operating Characteristic (ROC) curve, and the sensitivity and specificity for different HbA1c cut-off points were calculated subsequently. Results: Analysis showed that the mean age (p < 0.001) and BMI (p < 0.001) were significantly higher in the GDM group compared to those in non-GDM pregnant women. GDM participants reported positive family- and previous history of GDM more than healthy pregnant women (p = 0.04 and p < 0.001, respectively). All the markers for Lipid profile were significantly different between the two groups (p = <0.001) except for total cholesterol. The rate of Caesarean section and neonate’s Apgar score were not significantly different between the two groups. The best equilibrium between sensitivity (80%) and specificity (76%) for HbA1c was 5.05%. Conclusion: Our results suggest that pregnant women with HbA1c of ≥ 5.05% should proceed with an OGTT. Further investigations with larger sample size are needed to provide more robust evidence for the diagnostic and screening value of HbA1c in identifying pregnant women with GDM.
format Online
Article
Text
id pubmed-5664988
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Tehran University of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-56649882017-11-07 The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus Mousavi, Seyedeh Neda Kamali, Koorosh Mirbazel, Motahareh Jameshorani, Maryam J Family Reprod Health Original Article Objective: Gestational diabetes mellitus (GDM) is a prevalent disorder which increases maternal and fetal complications. The oral glucose tolerance test (OGTT) is a traditional, time -consuming and intensive test which is poorly tolerated by pregnant women. To date, increasing evidence considered HbA1c as a screening tool and reported various cut-off values in different populations. In alignment with existing literature, we determined for the first time, the optimal cut-off value for HbA1c in Iranian women with GDM. Materials and methods: This case-control study was conducted in Valie-Asr hospital between June 2015 and March 2016. A total of 200 pregnant women who were diagnosed with GDM were selected as study cases. For the control group, 200 healthy women were randomly selected. Fasting blood samples were taken for biochemical analysis, and OGTT was done in all participants. Demographic and anthropometric indexes were measured. Performance of the HbA1c test was analyzed by the Receiver Operating Characteristic (ROC) curve, and the sensitivity and specificity for different HbA1c cut-off points were calculated subsequently. Results: Analysis showed that the mean age (p < 0.001) and BMI (p < 0.001) were significantly higher in the GDM group compared to those in non-GDM pregnant women. GDM participants reported positive family- and previous history of GDM more than healthy pregnant women (p = 0.04 and p < 0.001, respectively). All the markers for Lipid profile were significantly different between the two groups (p = <0.001) except for total cholesterol. The rate of Caesarean section and neonate’s Apgar score were not significantly different between the two groups. The best equilibrium between sensitivity (80%) and specificity (76%) for HbA1c was 5.05%. Conclusion: Our results suggest that pregnant women with HbA1c of ≥ 5.05% should proceed with an OGTT. Further investigations with larger sample size are needed to provide more robust evidence for the diagnostic and screening value of HbA1c in identifying pregnant women with GDM. Tehran University of Medical Sciences 2017-03 /pmc/articles/PMC5664988/ /pubmed/29114267 Text en Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Mousavi, Seyedeh Neda
Kamali, Koorosh
Mirbazel, Motahareh
Jameshorani, Maryam
The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus
title The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus
title_full The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus
title_fullStr The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus
title_full_unstemmed The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus
title_short The Best Cut-Off Value for HbA1c as a Screening Tool in Iranian Women With Gestational Diabetes Mellitus
title_sort best cut-off value for hba1c as a screening tool in iranian women with gestational diabetes mellitus
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664988/
https://www.ncbi.nlm.nih.gov/pubmed/29114267
work_keys_str_mv AT mousaviseyedehneda thebestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus
AT kamalikoorosh thebestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus
AT mirbazelmotahareh thebestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus
AT jameshoranimaryam thebestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus
AT mousaviseyedehneda bestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus
AT kamalikoorosh bestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus
AT mirbazelmotahareh bestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus
AT jameshoranimaryam bestcutoffvalueforhba1casascreeningtooliniranianwomenwithgestationaldiabetesmellitus