期刊
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION
卷 82, 期 2, 页码 123-131出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/00365513.2022.2033827
关键词
Reference values; liquid chromatography; mass spectrometry; glycated albumin; glycated hemoglobin A1c; gestational diabetes
资金
- Stavanger University Hospital [501 702]
- Johan Selmer Kvanes Foundation [17/5196]
- Dr. Nils Henrichsen and wife Anna Henrichsen's foundation [811084]
This study aimed to establish the reference interval and assess the accuracy of glycated albumin (GA) and glycated hemoglobin A1c (HbA1c) in diagnosing gestational diabetes mellitus (GDM) in nulliparous pregnant women. The study found that neither GA nor HbA1c could effectively discriminate between those with and without GDM, and different diagnostic guidelines resulted in different rates of GDM diagnosis.
Glycated albumin (GA) may be a useful biomarker of glycemia in pregnancy. The aim of this study was to establish the reference interval (RI) for GA, analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), in healthy, nulliparous pregnant women. In addition, we assessed the accuracy of GA and glycated hemoglobin A1c (HbA1c) in the diagnosis of gestational diabetes mellitus (GDM). Finally, we explored the prevalence of GDM in healthy nulliparas, comparing three diagnostic guidelines (WHO-1999, WHO-2013 and the Norwegian guideline). The study was carried out at Stavanger University Hospital, Norway, and included a study population of 147 pregnant nulliparous women. An oral glucose tolerance test (OGTT) was performed and used as the gold standard for GDM diagnosis. Blood samples for analysis of GA and HbA1c were collected at pregnancy week 24-28. A nonparametric approach was chosen for RI calculation, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of GA and HbA1c. The established RI for GA in 121 pregnant women was 7.1-11.6%. The area under the ROC curves (AUCs) were 0.531 (GA) and 0.627 (HbA1c). According to the WHO-1999, WHO-2013 and the Norwegian guideline, respectively, 24 (16%), 36 (24%) and 21 (14%) women were diagnosed with GDM. Only nine women (6%) fulfilled the GDM-criteria of all guidelines. In conclusion, we established the first LC-MS/MS-based RI for GA in pregnant women. At pregnancy weeks 24-28, neither GA nor HbA1c discriminated between those with and without GDM. Different women were diagnosed with GDM using the three guidelines.
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