Establishment Of Normal Reference Value Range Of Glycated Albumin In Pregnant Women In Xi'an City

Objectives: Gestational diabetes refers to different degrees of abnormal glucose metabolism during pregnancy,but blood glucose does not reach the level of dominant diabetes,and it is one of the most common medical complications during pregnancy.GDM is a high-risk pregnancy.The metabolic environment of high blood glucose will lead to spontaneous abortion,macrosomia,pre-eclampsia and other adverse pregnancy outcomes.Strict blood glucose control can improve the pregnancy outcome of GDM mothers and infants.Glycated Albumin?GA?is the product of a non-enzymatic reaction between blood glucose and serum albumin,which reflects the average blood glucose level 2 to 3 weeks before blood collection.The 2017 version of the Chinese Diabetes Prevention and Treatment Guidelines pointed out that GA is a good indicator for evaluating the short-term glucose metabolism control of diabetic patients.Studies have shown that GA is also suitable for the monitoring of GDM patients with large changes in blood glucose in a short period of time.However,the clinical application time of GA is relatively short,and it varies greatly in different pregnancy periods of gestational diabetes patients.At present,there is no recognized normal value range.Comprehend the change trend of GA during pregnancy and its relationship with blood glucose,and provide a good monitoring index of glucose metabolism for the diagnosis and treatment of GDM patients.Methods: From April to December 2019,377 healthy pregnant women with normal glucose metabolism in the obstetrics department of Xi'an Central Hospital were selected as the normal pregnant women group.According to the gestational week,they were divided into the first trimester(?12⁺⁶weeks)124 people,the second trimester(13²7⁺⁶weeks)111 people,142 people in the third trimester??28 weeks?;107 healthy women of childbearing age who were taken Physical examination in Xi'an Central Hospital in December 2019 were selected as the healthy women of childbearing age group.Collect the general data of all the research subjects,and select fasting venous blood to measure GA,FPG,liver function,renal function,thyroid function and other related indicators.SPSS 25.0 software was used for statistical processing and analysis.The measurement data is expressed by???±s.Data that conforms to a normal distribution,Two independent sample t tests were used for comparison between two groups,Comparison between multiple groups using one-way analysis of variance?One-Way ANOVA?.Non-normal distribution data was analyzed using nonparametric tests?Mann-Whitney U,Kruskal-Wallis H?,and correlation analysis was performed using Spearman correlation test.P<0.05 indicated that the difference was statistically significant.The reference value range adopts the percentile method,and the 2.5th to 97.5th percentile of GA is taken as the normal reference value range.Results:1.In the normal pregnant women group,FPG in the second trimester was lower than that of the first trimester,and the difference was statistically significant?P <0.05?,there was no obvious change from the second trimester to the third trimester.The FPG of healthy women of childbearing age group was higher than that of normal pregnant women group in the first,second and third trimesters of pregnancy,and the difference was statistically significant?P <0.05?.2.In the normal pregnant women group,GA showed a gradual downward trend with the progress of pregnancy,and the differences between each pregnancy period were statistically significant?P<0.05?.There was no significant difference in GA between healthy women of childbearing age and normal pregnant women in the first trimester?P> 0.05?.Compared with the second and third trimesters of pregnancy,it was higher than those in the second and third trimesters of pregnancy,and the differences were statistically significant?P<0.05?.3.In the normal pregnant women group,the FPG was significantly positively correlated with GA?r were 0.181,0.226,0.205,P values were less than 0.05?.The FPG and GA in healthy women of childbearing age group were significantly positively correlated?r = 0.318,P<0.05?.There was no significant correlation between GA and gestational weeks in the first trimester?P>0.05?.GA in the second and third trimesters was significantly negatively correlated with gestational age?r was-0.283 and-0.331,respectively,and the P values were all less than 0.05?.4.Using the percentile method,take the 2.5th to 97.5th percentiles of GA as the reference value range.The normal reference values of GA for pregnant women in the first,second and third trimesters are 9.38 14.01%,8.75 13.48%,8.25 13.12%.The normal reference value of GA for healthy women of childbearing age is 10.21¹4.22%.Conclusions:1.The normal reference range of GA in the first trimester,second trimester and third trimester of pregnant women in the urban area of Xi'an were 9.38¹4.01%?8.75¹3.48%?8.25¹3.12%.2.GA has a good correlation with FPG,which can reflect the control of women's blood glucose during pregnancy and it is a good indicator for women's blood glucose monitoring during pregnancy.