Hemoglobin A1c for diagnosis of postpartum abnormal glucose tolerance among women with gestational diabetes mellitus: diagnostic meta-analysis

Xudong Su, Zhaoyan Zhang, Xinye Qu, Yaqiang Tian, Guangzhen Zhang, Xudong Su, Zhaoyan Zhang, Xinye Qu, Yaqiang Tian, Guangzhen Zhang

Abstract

Objective: To evaluate the accuracy of glycosylated hemoglobin A1c (HbA1c) for the diagnosis of postpartum abnormal glucose tolerance among women with gestational diabetes mellitus (GDM).

Methods: After a systematic review of related studies, the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and other measures about the accuracy of HbA1c in the diagnosis of postpartum abnormal glucose tolerance were pooled using random-effects models. The summary receiver operating characteristic (SROC) curve was used to summarize the overall test performance.

Results: Six studies met our inclusion criteria. The pooled results on SEN, SPE, PLR, NLR, and DOR were 0.36 (95% CI 0.23-0.52), 0.85 (95% CI 0.73-0.92), 2.4 (95% CI 1.6-3.6), 0.75 (95% CI 0.63-0.88) and 3 (95% CI 2-5). The area under the summary receiver operating characteristic (SROC) curve was 0.67 with a Q value of 0.63.

Conclusions: Measurement of HbA1c alone is not a sensitive test to detect abnormal glucose tolerance in women with prior GDM.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Flowchart of study selection and…
Figure 1. Flowchart of study selection and specific reasons for exclusion from the meta-analysis.
Figure 2. QUADAS-2 Risk of bias assessment.
Figure 2. QUADAS-2 Risk of bias assessment.
Figure 3. Forest plot of sensitivity and…
Figure 3. Forest plot of sensitivity and specificity for HbA1c in the diagnosis of postpartum abnormal glucose tolerance.
Figure 4. Summary receiver operating characteristic cure…
Figure 4. Summary receiver operating characteristic cure (SROC) for HbA1c.
Each solid circle represents each study in the meta-analysis. AUC: area under curve.
Figure 5. Deeks funnel plot asymmetry test…
Figure 5. Deeks funnel plot asymmetry test of publication bias.

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Source: PubMed

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