论著 Original Article

ROC曲线法分析糖化血红蛋白在妊娠糖尿病诊断中的作用

Published at: 2014年第34卷第5期

姚碧容 1 , 谭建锡 2 , 成婧 2 , 龚强 2
1 湖南省妇幼保健院检验科,长沙 410013
2 湖南出入境检验检疫局检验检疫技术中心,长沙 410004
通讯作者 碧容 姚 Email: birogreen@126.com
DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2014.05.019
基金:

摘要

目的:采用接受者操作特性曲线(receiver operating characteristic,ROC)曲线统计学方法分析糖化血红 蛋白(glycosylated hemoglobin Alc,HbAlc)在妊娠糖尿病(gestational diabetes mellitus,GDM)的筛查与 诊断中的作用。方法:整理统计湖南省妇幼保健院2014年上半年2 283例24~28周产检孕妇的OGTT、 HbAlc结果,根据OGTT结果将受试者分为正常组和GDM组,采用2组独立样本的T检验统计学方法 分析2组HbAlc数据的差异性。以HbAlc值绘制诊断ROC曲线,分析HbAlc对于筛查诊断GDM的作用; 以≥5.7%为阳性标准,将HbAlc分成阴性、阳性结果,绘制诊断ROC曲线,分析HbAlc对于诊断筛查 GDM的作用。结果:正常组与GDM组HbAlc值的差异有统计学意义(P<0.05);以HbAlc值绘制诊断 ROC曲线,曲线下面积(area under curve,AUC)为0.661,95%置信区间范围为0.620~0.702;将HbAlc 值分成阴性、阳性结果绘制诊断ROC曲线,AUC为0.545,95%置信区间范围为0.502~0.588。结论: HbAlc只能考察检测前2月内的血糖平均水平,不能用作GDM早期筛查与诊断的标准。


Exploring the medical diagnostic performance of glycosylated hemoglobin to gestational diabetes mellitus using receiver operating characteristic plots

Abstract

Objective: To evaluate the accuracy of glycosylated hemoglobin A1c (HbA1c) for the diagnosis of gestational diabetes mellitus (GDM) using receiver operating characteristic (ROC) plots. Methods: Collected the value of OGTT and HbAlc of 2 283 pregnant women of 24~28 gestation week, distributed the subjects into normal pregnancy group and GDM group, compared the difference between the 2 groups using independent-samples T test, analyzed the diagnostic performance of HbAlc by ROC plots. Results: The difference of the HbAlc of normal pregnancy group and GDM group was significant (P<0.05). The area under curve (AUC) of ROC plots calculated by HbAlc value was 0.661, with the 95% confidence interval of 0.620~0.702. Set ≥5.7% as the positive criteria, the AUC of ROC plots was 0.554, with the 95% confidence interval of 0.502~0.588. Conclusion: HbAlc was not a sensitive test to the screening and diagnosing of early gestational diabetes mellitus.


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引用

引用本文: 碧容 姚, 建锡 谭, 婧 成, 强 龚. ROC曲线法分析糖化血红蛋白在妊娠糖尿病诊断中的作用[J]. 临床与病理杂志, 2014, 34(5): 542-545.
Cite this article as: YAO Birong, TAN Jianxi, CHENG Jing, GONG Qiang . Exploring the medical diagnostic performance of glycosylated hemoglobin to gestational diabetes mellitus using receiver operating characteristic plots [J]. Journal of Clinical and Pathological Research, 2014, 34(5): 542-545.