ROC曲线法分析糖化血红蛋白在妊娠糖尿病诊断中的作用
| 作者: |
1姚碧容,
2谭建锡,
2成婧,
2龚强
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: |
姚碧容
Email: birogreen@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2014.05.019 |
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。
关键词：
ROC曲线
妊娠糖尿病
糖化血红蛋白
Exploring the medical diagnostic performance of glycosylated hemoglobin to gestational diabetes mellitus using receiver operating characteristic plots
CorrespondingAuthor: YAO Birong Email: birogreen@126.com
DOI: 10.3978/j.issn.2095-6959.2014.05.019
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.