AIM To assess the efficacy of first trimester glycated hemoglobin (HbA1c-FT) in diagnosing or predicting gestational diabetes mellitus (GDM) in Asian Indian women. METHODS This retrospective cohort study involved 2275 women who underwent both HbA1c-FT estimation and GDM screening with a one-step 75 g oral glucose tolerance test. Receiver Operating Characteristic (ROC) curve statistics were applied to assess the discriminative ability of HbA1c-FT in GDM diagnosis. A multivariable logistic regression analysis after adjusting for plausible confounders was used to evaluate the independent effect of HbA1c-FT on GDM diagnosis. RESULTS The mean HbA1c-FT of GDM (n = 578) and non-GDM women (n = 1697) were 5.04 + 0.04% and 4.9 + 0.37%, respectively (p < 0.001). Compared to women with a HbA1c-FT < 5.2%, the adjusted odds ratio to develop GDM of women with an HbA1c-FT range of 5.2-5.5% and those >5.6% to develop GDM were 1.627 (p < 0.004) and 2.6 (p < 0.001), respectively. The area under the ROC curve to detect GDM was 0.606 (95% CI: 0.519-0.633 p < 0.001), but the sensitivity and specificity of the HbA1c-FT were not sufficient to diagnose, rule in or rule out GDM. CONCLUSIONS HbA1c-FT is an independent GDM predictor in Asian Indian women but lacks sufficient sensitivity or specificity for use as a diagnostic test.

中文翻译：

---

头三个月糖化血红蛋白：亚洲印度裔孕妇妊娠糖尿病的预测因子。

目的评估妊娠早期糖化血红蛋白（HbA1c-FT）在诊断或预测亚洲印度女性妊娠糖尿病（GDM）中的功效。方法这项回顾性队列研究纳入了2275名女性，这些女性均接受了一步一步75 g口服葡萄糖耐量试验，同时进行了HbA1c-FT评估和GDM筛查。接收者操作特征（ROC）曲线统计数据用于评估HbA1c-FT在GDM诊断中的判别能力。校正合理的混杂因素后，进行多因素logistic回归分析，以评估HbA1c-FT对GDM诊断的独立作用。结果GDM（n = 578）和非GDM妇女（n = 1697）的平均HbA1c-FT分别为5.04 + 0.04％和4.9 + 0.37％（p <0.001）。与HbA1c-FT <5.2％的女性相比，HbA1c-FT范围为5.2-5.5％的女性发生GDM的调整后优势比为1.627（p <0.004）和2.6（p <0.001）。ROC曲线下检测GDM的面积为0.606（95％CI：0.519-0.633 p <0.001），但是HbA1c-FT的敏感性和特异性不足以诊断，排除或排除GDM。结论HbA1c-FT是亚洲印度裔妇女的独立GDM预测因子，但缺乏足够的敏感性或特异性作为诊断测试。排除或排除GDM。结论HbA1c-FT是亚洲印度裔妇女的独立GDM预测因子，但缺乏足够的敏感性或特异性作为诊断测试。排除或排除GDM。结论HbA1c-FT是亚洲印度裔妇女的独立GDM预测因子，但缺乏足够的敏感性或特异性作为诊断测试。