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目的:探讨糖化血红蛋白(HbAlc)和C反应蛋白(CRP)在妊娠糖尿病(GDM)筛查与诊断中的价值。方法:对100例产科孕妇同时进行75 g口服葡萄糖耐量试验(OGTT)、HbAlc和CRP检查,按美国糖尿病协会(ADA)标准分为GDM组(50例)和非GDM组(50例),分析两组HbAlc和CRP结果。结果:GDM组HbAlc和CRP水平明显高于非GDM组(P<0.01);HbAlc筛查GDM的受试者工作特征(ROC)曲线下面积(AUC)为0.834(CI0.715～0.952);当HbAlc的Cutoff值为5.85%时,筛查GDM的敏感性为76%、特异性为84%、阳性预测值为81.5%、阴性预测值为87%。CRP的AUC为0.815(CI0.697～0.933),当CRP的Cutoff值为3.685mg/L时,筛查GDM的敏感性为76%、特异性为76%、阳性预测值和阴性预测值均为76%。结论:HbAlc和CRP是有希望的GDM筛查和诊断指标。
Objective: To investigate the value of HbAlc and C-reactive protein (CRP) in the screening and diagnosis of gestational diabetes mellitus (GDM). Methods: A total of 100 pregnant women undergoing oral glucose tolerance test (OGTT), HbAlc and CRP were divided into GDM group (n = 50) and non-GDM group (n = 50) according to American Diabetes Association (ADA) Two groups of HbAlc and CRP results. Results: The HbAlc and CRP levels in GDM group were significantly higher than those in non-GDM group (P <0.01). The area under the receiver operating characteristic (ROC) curve of HbAlc screening for GDM was 0.834 (CI 0.715-0.952) The Cutoff value of HbAlc was 5.85%, the sensitivity of screening for GDM was 76%, the specificity was 84%, the positive predictive value was 81.5%, and the negative predictive value was 87%. The AUC of CRP was 0.815 (CI 0.697-0.933). When the cutoff value of CRP was 3.685mg / L, the sensitivity and specificity of screening GDM were 76% and 76% respectively. The positive predictive value and negative predictive value of CRP were 76%. Conclusion: HbA1c and CRP are promising indicators of GDM screening and diagnosis.