Abstract:

Objective To investigate the roles of glycated hemoglobin A_1c（HbA_1c） and glycated albumin（GA） in screening gestational diabetes mellitus（GDM） among elderly pregnant women. Methods A total of 1 201 pregnant women ≥35 years old,including 626 cases of normal blood glucose（control group） and 575 cases of GDM,were enrolled. Blood glucose was determined by hexokinase method,HbA_1c was determined by high performance liquid chromatography,and GA was determined by enzymatic method. Patients with GDM were classified into 3 groups according to the results of oral glucose tolerance test（OGTT）（fasting blood glucose,1 h blood glucose and 2 h blood glucose）. Among them,there were 330 cases with 1 abnormal value,170 cases with 2 abnormal values and 75 cases with 3 abnormal values. The levels of HbA_1c and GA among these groups were compared. The correlation was analyzed by Pearson correlation analysis. The roles of HbA_1c and GA for the diagnosis of GDM were evaluated by receiver operating characteristic（ROC） curve and Logistic regression analysis. Results Compared with control group,the levels of HbA_1c and GA in GDM group were increased（P<0.01）. In patients with GDM,the HbA_1c level with 3 abnormal values was higher than those with 2 abnormal values and 1 abnormal value（P<0.01）. The GA levels with 3 abnormal values and 2 abnormal values were higher than that with 1 abnormal value（P<0.01）. The correlation analysis showed that HbA_1c and GA were positively correlated with fasting blood glucose（r=0.309 and 0.141,P<0.01）,and HbA_1c and GA were positively correlated（r=0.206,P<0.01）. ROC curve showed that the area under curve [95% confidence interval（CI）] of HbA_1c and GA combined determination was 0.851（0.821-0.881）,which was better than those of single determinations. Conclusions The combined determination of HbA_1c and GA plays a role in the diagnosis of GDM among elderly pregnant women.

Key words: Glycated hemoglobin A_1c, Glycated albumin, Elderly pregnant woman, Gestational diabetes mellitus