题名：Influence of insulin sensitivity and secretion on glycated albumin and hemoglobin A1c in pregnant women with gestational diabetes mellitus.
作者：PAN J; ZHANG F; ZHANG L; BAO Y; TAO M; JIA W;
来源：Int J Gynaecol Obstet. 2013 Jun;121(3):252-6. doi: 10.1016/j.ijgo.2013.01.017. [ IF= 0.00 ] ]
摘要：OBJECTIVE: To examine the differential effects of insulin sensitivity and
secretion on hemoglobin A1c (HbA1c) and glycated albumin (GA) at 24-32weeks of
pregnancy in women with gestational diabetes mellitus (GDM). METHODS: A
cross-sectional, sequential case series study was performed in pregnant women
with an abnormal 50-g oral glucose-screening test. Hemoglobin A1c and GA
measurements were taken during oral glucose tolerance test (OGTT). The
homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell
function (HOMA-%beta), insulin sensitivity index (ISOGTT), and modified
insulinogenic index were calculated to assess insulin sensitivity and secretory
function. RESULTS: A total of 713 pregnant women were enrolled. The GDM group had
lower ISOGTT and insulinogenic index scores, and a higher HOMA-IR score.
Hemoglobin A1c was positively correlated with HOMA-IR. Glycated albumin was
negatively correlated with insulinogenic index and HOMA-%beta. Multiple
regression analysis revealed that HbA1c was independently associated with
diastolic pressure, 0- and 120-minute glucose, and HOMA-IR; GA was independently
associated with 0- and 120-minute glucose. CONCLUSION: Compared with HbA1c, GA is
more closely correlated with fasting and postprandial glucose, regardless of
insulin resistance and blood pressure, and might be a better monitoring index in
women with GDM.