Is there a role for glycated albumin in the diagnosis of gestational diabetes mellitus?
BACKGROUND
Studies in the general population have advocated glycated albumin (GA) as a useful alternative to glycated haemoglobin (HbA1c) under conditions wherein the latter does not reflect glycaemic status accurately. There are few studies in other populations, especially in pregnant women. Therefore, the aim of this study was to assess the clinical utility of GA in the diagnosis of gestational diabetes mellitus (GDM).


MATERIALS AND METHODS
This diagnostic test accuracy study was performed in 149 Brazilian women at 24-28 weeks of gestation referred for an oral glucose tolerance test (OGTT) in a tertiary university hospital. Receiver Operating Characteristic (ROC) curves were used to access the performance of GA and HbA1c in the diagnosis of GDM by the reference OGTT.


RESULTS
GDM by OGTT (IADPSG criteria) was detected in 18.8% of participants. According to ROC analysis, the area under the curve (AUC) for GA was 0.531 (95% CI: 0.405-0.658, p = 0.065) lower than that for HbA1c [0.743 (95% CI: 0.636-0.849; p ≤ 0.001] for the detection of GDM (p = 0.004). The equilibrium cut-off value for GA was 12.6%; sensitivity and specificity in this cut-off point were 53.6% and 54.2%, respectively.


CONCLUSIONS
GA at 24-28 weeks of gestation does not have ability to correctly discriminate those with and without GDM. In summary, the lack of sensitivity found in our results do not support the solely use of GA in the diagnosis of GDM.
['Chume|Fernando Chimela|FC|', 'Renz|Paula Breitenbach|PB|', 'Hernandez|Mayana Kieling|MK|', 'Freitas|Priscila Aparecida Correa|PAC|', 'Camargo|Joíza Lins|JL|0000-0001-8834-4075']
D001786:Blood Glucose D001938:Brazil D016640:Diabetes, Gestational D005260:Female D006442:Glycated Hemoglobin A D017127:Glycation End Products, Advanced D006801:Humans D011247:Pregnancy D012709:Serum Albumin
Glycated albumin Gestational diabetes mellitus HbA1c Oral glucose tolerance test Diagnostic accuracy