孕中期空腹血糖与糖化血红蛋白联合检测对妊娠期糖尿病的诊断价值OA

Objective To evaluate the diagnostic value of combining fasting plasma glucose(FPG)and glycated hemoglobin(HbA1c)measurements during the second trimester of pregnancy(24-28 weeks)for gestational diabetes mellitus(GDM).Methods A retrospective analysis was conducted on the case data of 5 400 singleton pregnant women who underwent prena-tal examination at Dongguan Renkang Hospital from September 2018 to December 2024.Based on the International Associ-ation of Diabetes and Pregnancy Study Groups(IADPSG)criteria and the 75 g oral glucose tolerance test(OGTT),1 505 women were diagnosed with GDM(GDM group),and 3 895 women had normal glucose levels(control group).FPG and HbA1c levels were measured and compared between the two groups.The diagnostic performance of FPG alone,HbA1c alone,and their combination for GDM was assessed,including sensitivity,specificity,and ROC curves.Results FPG and HbA1c levels in the GDM group were higher than those in the control group,the differences were statistically significant(P＜0.001).The combination of FPG and HbA1c for GDM diagnosis yielded a sensitivity of 57.9%,a specificity of 88.9%,and an AUC of 0.784.The AUC of the combined detection was higher than that of FPG alone(AUC=0.767,P＜0.001)and HbA1c alone(AUC=0.674,P＜0.001).Conclusion The combined detection of FPG and HbA1c in the second trimester of pregnancy demonstrates good diagnostic efficacy for GDM.Its overall performance(sensitivity,specificity,and AUC)is superior to that of either indicator alone,suggesting its potential as an effective auxiliary screening tool with promising clinical application prospects.