Gestational diabetes: An evaluation of serum fructosamine as a screening test in a high-risk population

Mukesh M. Agarwal, Gurdeep S. Dhatt, Yusra Othman, Milos R. Ljubisavljevic

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Aim: To evaluate the value of serum fructosamine as a screening test for gestational diabetes mellitus (GDM). Methods: 849 pregnant women underwent the one-step 75 g oral glucose tolerance test (OGTT) for universal screening of GDM. The fasting serum fructosamine (cFruc) was assessed using the area under the receiver operating characteristic curve (AUC). The GDM diagnostic criteria used were those of the American Diabetes Association; however, the cFruc performance was also evaluated using criteria of the World Health Organization, Australian (ADIPS), European (EASD) and International Association of Diabetes and Pregnancy Study Groups (IADPSG). Results: 113 (13.3%) women had GDM. The AUC of the cFruc was 0.60 (95% CI 0.54-0.66). A cFruc threshold of 237 μmol/l achieved an acceptable sensitivity of 85.8% (95% CI 78.0-91.0%), but the associated specificity remained poor at 23.4% (95% CI 20.0-27.0%) with a positive predictive value of just 14.7%. Overall, over 4 out of 5 pregnant women, being over this cutoff, would need the confirmatory OGTT. No cFruc threshold reached acceptable likelihood ratios to rule-in or rule-out GDM. The AUC for cFruc remained unacceptable independent of the diagnostic criteria. Conclusions: Despite all the advances in technology, serum fructosamine is a poor test to screen for GDM.

Original languageEnglish
Pages (from-to)207-212
Number of pages6
JournalGynecologic and Obstetric Investigation
Volume71
Issue number3
DOIs
Publication statusPublished - Apr 2011
Externally publishedYes

Keywords

  • Fructosamine
  • Gestational diabetes
  • International Association of Diabetes and Pregnancy Study Groups
  • Screening

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Fingerprint

Dive into the research topics of 'Gestational diabetes: An evaluation of serum fructosamine as a screening test in a high-risk population'. Together they form a unique fingerprint.

Cite this