CAJ | 학술논문

目的：评估糖化血红蛋白（HbA1 c ）和血清糖化白蛋白（GA）在妊娠期糖尿病（GDM）患者早期监测中的作用。方法根据美国糖尿病协会（ADA）建议，以口服75 g葡萄糖耐量试验（OGTT）测定值作为诊断GDM的标准，将98例妊娠妇女（孕期22～24周）分为正常妊娠组50例、GDM组48例，同时测定2组的HbA1 c和GA，并进行统计学分析及受试者工作特征（ROC ）曲线分析。结果 GDM组的HbA1 c和GA明显高于正常妊娠组（P＜0．01）。当HbA1c的Cut-off值为5．15％时，ROC 曲线下面积为0．954±0．020，敏感性为87．5％，特异性为92．0％。当GA的Cut-off值12．50％时，ROC曲线下面积为0．910±0．029，敏感性为81．3％，特异性为84．0％。HbA1c和GA联合诊断GDM的敏感性为70．8％、特异性为98．0％。结论当HbA1c ＞5．15％和GA＞12．50％时，诊断GDM的敏感度和特异性较高。HbA1 c和GA联合检测对GDM有重要价值。
목적：평고당화혈홍단백（HbA1 c ）화혈청당화백단백（GA）재임신기당뇨병（GDM）환자조기감측중적작용。방법근거미국당뇨병협회（ADA）건의，이구복75 g포도당내량시험（OGTT）측정치작위진단GDM적표준，장98례임신부녀（잉기22～24주）분위정상임신조50례、GDM조48례，동시측정2조적HbA1 c화GA，병진행통계학분석급수시자공작특정（ROC ）곡선분석。결과 GDM조적HbA1 c화GA명현고우정상임신조（P＜0．01）。당HbA1c적Cut-off치위5．15％시，ROC 곡선하면적위0．954±0．020，민감성위87．5％，특이성위92．0％。당GA적Cut-off치12．50％시，ROC곡선하면적위0．910±0．029，민감성위81．3％，특이성위84．0％。HbA1c화GA연합진단GDM적민감성위70．8％、특이성위98．0％。결론당HbA1c ＞5．15％화GA＞12．50％시，진단GDM적민감도화특이성교고。HbA1 c화GA연합검측대GDM유중요개치。
Objective To evaluate the utilities of glycosylated hemoglobin A1 c (HbA1 c ) and serum glycated albumin(GA)for the early monitoring of gestational diabetes mellitus(GDM).Methods A total of 98 pregnant women with their estimated gestational age between 22 and 24 weeks were enrolled for GDM diagnosis using 75 g oral glucose tolerance test (OGTT)based on American Diabetes Association (ADA)criteria,and were classified into normal pregnancy group (50 cases)and GDM group (48 cases).HbA1 c and GA were also determined simultaneously,and the results were analyzed statistically and by receiver operating characteristic (ROC)curve.Results The HbA1 c and GA levels in GDM group were significantly higher than those in normal pregnancy group(P<0.01 ).The area under ROC curveofHbA1cwas0.954±0.020atthecut-offvalueof5.15% withsensitivityof87.5% andspecificityof92.0%. The area under ROC curve of GA was 0.91 0 ±0.029 at the cut-off value of 1 2.50% with sensitivity of 81 .3% and specificity of 84.0%.The sensitivity was 70.8%,and the specificity was 98.0% in diagnosing GDM by the combined determination of HbA1c and GA.Conclusions When HbA1c >5.15% and GA>12.50%,there are high sensitivity and specificity for the diagnosis of GDM.The combined determination of HbA1 c and GA has the significance for the diagnosis of GDM.