The diagnostic value of glycated albumin in gestational diabetes mellitus

Zhu, Jiaan; Chen, Yu; Li, Changbin; Tao, Minfang; Teng, Yincheng

doi:10.1007/s40618-016-0605-7

Cited by 26 publications

(21 citation statements)

References 26 publications

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“…We compared the GlyA levels of pregnant women with and without GDM at the 24-28 weeks of gestation and found no significant difference (P = 0.993) between the two groups. This result was consistent with a study conducted by Zhu et al [22], in which no statistical GlyA difference was observed between the patients with and without GDM. In current practice, GDM was diagnosed during 24-28 weeks of gestations by FPG and postprandial plasma glucose levels.…”

Section: Discussionsupporting

confidence: 93%

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Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Dong

Zhai

Wang

et al. 2020

BMC Pregnancy Childbirth

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Background: Many efforts have been focused on the alternative glycemic marker glycated albumin (GlyA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GlyA in healthy Chinese pregnant women and to assess the predictive value of serum GlyA in adverse pregnancy outcomes. Methods: Totally 421 healthy subjects including 137 in the first trimester, 152 in the second trimester, and 132 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GlyA. In addition, 67 pregnant women diagnosed with GDM were enrolled at 24-28 weeks of gestation. The diagnostic value of GlyA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24-28 weeks of gestation. The association between GlyA in the late pregnancy and the adverse pregnancy outcomes was analyzed with the data collected from January to June 2018 at our hospital. Results: The estimated RIs of GlyA in present study were 11.26-15.10%, 10.04-13.50%, and 9.76-13.09% in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GlyA and 0.705 for FPG. More importantly, the GlyA level in the third trimester was not more elevated in the patients with adverse pregnancy outcomes including large for gestational age (LGA), preterm delivery, hypertension and preeclampsia (PE). The exception was made with the GDM patients who suffered from postpartum hemorrhage and had significantly higher GlyA levels than the control group. Conclusions: Our results showed that the GlyA was continuously decreased as the gestational age went up. The GlyA testing has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

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Section: Discussionsupporting

confidence: 93%

“…As a non-traditional glycemic marker, the limited diagnostic value of GlyA in GDM has been reported in several articles. Zhu et al [22] reported that the AUC values were 0.726 for FPG and only 0.542 for GlyA in the second trimester. Similar observation was made by Saglam et al [25], with the AUC of GlyA being 0.550 in the GDM diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Dong

Zhai

Wang

et al. 2020

BMC Pregnancy Childbirth

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“…We compared the GA levels of pregnant women with and without GDM at the 24-28 weeks of gestation and found no significant difference (P = 0.824) between the two groups. This result was consistent with a study conducted by Zhu et al [20], in which no statistical GA difference was observed between the patients with and without GDM who were less than 28 weeks of gestations.…”

Section: Discussionsupporting

confidence: 93%

“…In a study of 114 patients with GDM [22], the cut-off value of GA5.8 %, which was derived from the ROC curve had optimal specificity (100%) and poor sensitivity (17.1%) for diagnosing GDM. Zhu et al [20] reported that the AUC values were 0.726 for FPG and only 0.542 for GA in the second trimester. Similarly, observation was made by Saglam et al [23] with the AUC of GA being 0.550 in the GDM diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Glycated Albumin in Pregnancy: Reference Intervals Establishment and Its Predictive Value in Adverse Pregnant Outcomes

Dong

Zhai

Wang

et al. 2019

Preprint

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Background As one of the most common pregnant complications, the gestational diabetes mellitus (GDM) is associated with significant adverse pregnant outcomes and it is crucial to accurately monitor the glycemic states of GDM patients. The HbA1c which is a traditional long-term glycemic marker used in diabetic patients, is not recommended in GDM patients during pregnancy. Recently, many efforts have been focused on the alternative marker glycated albumin (GA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GA in healthy Chinese pregnant women and to assess the predictive value of serum GA in adverse pregnant outcomes. Methods Totally 479 healthy subjects including 153 in the first trimester, 174 in the second trimester, and 152 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GA. The diagnostic value of GA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24-28 weeks of gestation. The association between GA in the late pregnancy and the adverse pregnant outcomes was analyzed retrospectively with the data collected from January to June 2018 at our hospital. Results The estimated RIs of GA in present study were 10.87-15.09 %, 10.04-13.50 %, and 9.78-13.03 % in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GA and 0.705 for FPG. More importantly, the GA levels of the third trimester did not show significant changes in women with large-for-date birth weight, preterm delivery, postpartum hemorrhage or hypertension when compared in women with normal pregnancy outcomes. The exception was that the GDM patients who developed preeclampsia did have a lower GA level in their late pregnancy. Conclusions Our results show that the GA was continuously decreased as the gestational age went up. It has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

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“…In comparison, there was no significant increase in the incidence in the group of women with HbA1c of more than 5.7% compared with the group of women with HbA1c of 5.7% or less [20] which suggests that GA is preferable. While it may be better than HbA1c for monitoring diabetes it does not appear to perform better than HbA1c when used for screening [21].…”

Section: Anaemiamentioning

confidence: 97%

Haemoglobin A1c or Glycated Albumin for Diagnosis and Monitoring Diabetes: An African Perspective

George

Erasmus

2018

Ind J Clin Biochem

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Diabetes mellitus (DM) has reached epidemic proportions across the globe with the largest increases seen in sub-Saharan Africa. Those that are diagnosed are largely poorly controlled. This review summarizes the limitations of the use of glycated haemoglobin (HBA1c) in Africa and current knowledge on the utility of glycated albumin and fructosamine in African patients. The diagnosis and monitoring of DM in African patients may be compromised by associated conditions like sickle cell anaemia, chronic kidney disease and HIV infection. Glycated albumin reflects short term glycaemia and is not affected by many conditions that alter HbA1c. It can be measured enzymatically, and this review discusses methods for analysis, and discusses the advantages and limitations in specific situations with an emphasis on conditions that also affect HbA1c.

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The diagnostic value of glycated albumin in gestational diabetes mellitus

Cited by 26 publications

References 26 publications

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Glycated Albumin in Pregnancy: Reference Intervals Establishment and Its Predictive Value in Adverse Pregnant Outcomes

Haemoglobin A1c or Glycated Albumin for Diagnosis and Monitoring Diabetes: An African Perspective

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