The Value Analysis Of Mid-pregnancy Fasting Plasma Glucose,GA And HbA1c For Gestational Diabetes Mellitus With Normal Fasting Plasma Glucose

Objective: The purpose of this study was to investigate the diagnostic value of midpregnancy glycoalbumin and glycosylated hemoglobin A1 cin patients with gestational diabetes with normal fasting plasma glucose.Methods: By using the retrospective study method,Randomly selected from2017-01-01 to 2017-06-30 in nanjing medical university changzhou maternal and child health care clinic regular prenatal mid pregnancy for the first time(14-16 14-16 weeks of gestation),fasting glucose,fasting plasma glucose,FPG)< 5.1 tendency/L gestational diabetes(gestational diabetes mellitus.186 cases of patients with GDM and 171 cases of pregnant women with 75 g oral glucose tolerance test(OGTT)were selected as GDM group(g group)and control group(N group),respectively.According to the different levels of mid-pregnancy first time(14-16 weeks of gestation)FPG(fasting plasma glucose,FPG)(FPG <4.4mmol/L,4.4mmol/L ? FPG < 5.1mmol/L),the women were further divided into G1 group(114 cases)and N1 group(91 cases),G 2 group(72 cases)and N2 group(80 cases).The difference of maternal age,pre pregnancy BMI,gravidity,parity,weight gain,first FPG of mid-pregnancy,OGTT(0-1-2h),GA and glycated hemoglobin(Hb A1c)were compared in each two groups.Each correlation between FPG,Hb A1 c and GA was analyzed by Pearson.The diagnostic value of FPG,Hb A1 c and GA for the prediction of GDM was analyzed by the ROC curve.Results: 1 ? The level of first time(14-16 weeks of gestation)FPG < 5.1mmol/L,compared to the control group,the GDM group had a significantly higher of maternal age,OGTT(1-2h),GA and Hb A1 c,and lower of weight gain(P < 0.05);there wereno significant difference between the two groups in pre pregnancy BMI,gravidity,parity,OGTT(0h)and FPG(P?0.05).The area under the ROC curve predicted by FPG was 0.504,the best diagnostic value was 4.425mmol/L,the GDM sensitivity was 38.7% and the specificity was 55.6%;The area under the ROC curve predicted by Hb A1 c was 0.647,the best diagnostic value was 5.25%,the GDM sensitivity was30.1% and the specificity was 84.8%;the area under the ROC curve predicted by GA was 0.576,the best diagnostic value was 11.05%,the GDM sensitivity was 47.8%and the specificity was 66.7%.2?FPG < 4.4mmol/L,the maternal age,OGTT(1-2h)and Hb A1 c in G1 group were significantly higher than those in the N1 group,the difference was statistically significant(P< 0.05);there were no statistical difference in pre pregnancy BMI,gravidity,parity,weight gain,OGTT(0h),FPG and GA in the G1 and N1 group(P?0.05).3?4.4mmol/L ?FPG < 5.1mmol/L,the maternal age,OGTT(0-1-2h),FPG,GA and Hb A1 c of the G2 group were significantly higher than the N2 group(P< 0.05);there were no significant difference in pre pregnancy BMI,gravidity,parity,weight gain between G2 and N2 group(P?0.05).The area under the ROC curve predicted by FPG was 0.715,the best diagnostic value was4.715mmol/L,the GDM sensitivity was 55.6% and the specificity was 80%;The area under the ROC curve predicted by Hb A1 c was 0.643,the best diagnostic value was5.35%,the GDM sensitivity was 31.9% and the specificity was 78.7%;the area under the ROC curve predicted by GA was 0.626,the best diagnostic value was 11.45%,the GDM sensitivity was 77.8% and the specificity was 45.0%.Conclusion: There is a good positive correlation between FPG,Hb A1 c and GA?The level of mid-pregnancy FPG among the normal range,especially 4.4mmol/L ?FPG <5.1mmol/L,the FPG,Hb A1 c and GA values of pregnant women have certain diagnostic value for GDM.