title: Diagnostic accuracy of glycosylated hemoglobin in chinese patients with gestational diabetes mellitus: a meta-analysis based on 2,812 patients and 5,918 controls.
abstract: OBJECTIVE
  The accuracy of glycosylated hemoglobin (HBA1c) detection for the diagnosis of gestational diabetes mellitus (GDM) has been extensively studied in the Chinese population, but the exact role of these detections remains controversial. The present meta-analysis was performed to establish the overall accuracy of HBA1c for the diagnosis of Chinese patients with 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 GDM were pooled using random-effects models. The summary receiver operating characteristic (SROC) curve analysis was used to summarize the overall test performance.
  
  
  RESULTS
  Forty-one studies included 2812 Chinese patients with GDM and 5918 controls were included in our meta-analysis. The summary estimates for HBA1c in the diagnosis of GDM in the studies included were as follows: sensitivity 0.762 (95% confidence interval [CI]: 0.746-0.777), specificity 0.917 (95% CI: 0.910-0.924), PLR 8.21 (95% CI: 3.77-17.89), NLR 0.20 (95% CI: 0.09-0.44), and DOR 41.40 (95% CI: 11.47-149.38). Our data showed that the SROC curve is positioned near the desirable upper left corner of the SROC curve, while the area under curve (AUC) was 0.93 with a Q* value of 0.865.
  
  
  CONCLUSIONS
  Measurement of HBA1c is likely to be a useful diagnostic tool for confirming GDM. The results of HBA1c should be interpreted in parallel with clinical findings and the results of conventional tests.
authors.affiliation: Department of Clinical Laboratory, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China.
authors.forename: Qing-Wu
authors.initials: QW
authors.lastname: Tian
authors.forename: Chao
authors.initials: C
authors.lastname: Xuan
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Wang
authors.forename: Jin-Xia
authors.initials: JX
authors.lastname: Zhao
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Yu
authors.forename: Ge
authors.initials: G
authors.lastname: Gao
authors.forename: Bei-Bei
authors.initials: BB
authors.lastname: Zhang
authors.forename: Li-min
authors.initials: LM
authors.lastname: Lun
mesh_terms: D000328:Adult; D044466:Asian People; D002681:China; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human