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The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals

BACKGROUND: This study aims to investigate the diagnostic value of the glycated hemoglobin (HbA1c) test for detecting gestational diabetes mellitus (GDM) in pregnant Chinese patients. METHODS: We enrolled a large cohort of 19,261 pregnant individuals who had both oral glucose tolerance test (OGTT) a...

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Autores principales: Lai, Yi, Chen, Hanxiao, Du, Ze, Zhou, Shu, Xu, Wenming, Li, Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475463/
https://www.ncbi.nlm.nih.gov/pubmed/32953814
http://dx.doi.org/10.21037/atm-20-5464
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author Lai, Yi
Chen, Hanxiao
Du, Ze
Zhou, Shu
Xu, Wenming
Li, Tao
author_facet Lai, Yi
Chen, Hanxiao
Du, Ze
Zhou, Shu
Xu, Wenming
Li, Tao
author_sort Lai, Yi
collection PubMed
description BACKGROUND: This study aims to investigate the diagnostic value of the glycated hemoglobin (HbA1c) test for detecting gestational diabetes mellitus (GDM) in pregnant Chinese patients. METHODS: We enrolled a large cohort of 19,261 pregnant individuals who had both oral glucose tolerance test (OGTT) and HbA1c test between 24 and 28 weeks of gestation in a large Chinese tertiary hospital consecutively from 2013 to 2018. We used Pearson’s correlation test to evaluate the correlation between OGTT and HbA1c. The diagnostic accuracy of HbA1c for GDM was examined with the receiver operating characteristic curve, using OGTT as the reference standard. RESULTS: A total of 3,547 (18.42%) women were diagnosed with GDM. HbA1c was positively, but only weakly correlated with the fasting, 1-hour glucose, and 2-hour glucose (r=0.31, 0.24, and 0.25, respectively, all P<0.001). The area under the curve of the HbA1c level for detecting GDM was 0.664 (95% CI: 0.653–0.674, P<0.01). The optimal cut-off point of HbA1c for GDM diagnosis was determined at 5.0% (31 mmol/mol), which yielded a sensitivity of 60.1%, a specificity of 65.3%, a positive predictive value of 28.1%, and a negative predictive value of 87.9%. CONCLUSIONS: HbA1c test is weakly correlated with OGTT during pregnancy, and it offers only limited value in diagnosing GDM among Chinese pregnant individuals.
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spelling pubmed-74754632020-09-17 The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals Lai, Yi Chen, Hanxiao Du, Ze Zhou, Shu Xu, Wenming Li, Tao Ann Transl Med Original Article BACKGROUND: This study aims to investigate the diagnostic value of the glycated hemoglobin (HbA1c) test for detecting gestational diabetes mellitus (GDM) in pregnant Chinese patients. METHODS: We enrolled a large cohort of 19,261 pregnant individuals who had both oral glucose tolerance test (OGTT) and HbA1c test between 24 and 28 weeks of gestation in a large Chinese tertiary hospital consecutively from 2013 to 2018. We used Pearson’s correlation test to evaluate the correlation between OGTT and HbA1c. The diagnostic accuracy of HbA1c for GDM was examined with the receiver operating characteristic curve, using OGTT as the reference standard. RESULTS: A total of 3,547 (18.42%) women were diagnosed with GDM. HbA1c was positively, but only weakly correlated with the fasting, 1-hour glucose, and 2-hour glucose (r=0.31, 0.24, and 0.25, respectively, all P<0.001). The area under the curve of the HbA1c level for detecting GDM was 0.664 (95% CI: 0.653–0.674, P<0.01). The optimal cut-off point of HbA1c for GDM diagnosis was determined at 5.0% (31 mmol/mol), which yielded a sensitivity of 60.1%, a specificity of 65.3%, a positive predictive value of 28.1%, and a negative predictive value of 87.9%. CONCLUSIONS: HbA1c test is weakly correlated with OGTT during pregnancy, and it offers only limited value in diagnosing GDM among Chinese pregnant individuals. AME Publishing Company 2020-08 /pmc/articles/PMC7475463/ /pubmed/32953814 http://dx.doi.org/10.21037/atm-20-5464 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Lai, Yi
Chen, Hanxiao
Du, Ze
Zhou, Shu
Xu, Wenming
Li, Tao
The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals
title The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals
title_full The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals
title_fullStr The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals
title_full_unstemmed The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals
title_short The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals
title_sort diagnostic accuracy of hba1c in detecting gestational diabetes mellitus among chinese pregnant individuals
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475463/
https://www.ncbi.nlm.nih.gov/pubmed/32953814
http://dx.doi.org/10.21037/atm-20-5464
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