| BackgroundGlycated albumin(GA)is a intermediate-term glycemic marker which reflects the average glucose concentration over the preceding 2-4 weeks.It was used to monitor the changes of blood glucose and guide the adjustment of diabetes treatment.Our object is to search and summarize available evidence on the utility of glycated albumin measurements for the diagnosis of diabetes mellitus(DM).MethodWe systematically searched Chinese National Knowledge Infrastructure(CNKI),Chinese Medical Association(CMA)Digital Periodicals of Wanfang,VIP,Medline,Embase,Web of Science,and Cochrane Central Register of Controlled Trials(CENTRAL)and other database or websites.QUADAS-2 tool were applied for the quality assessment.Bivariate model was used to pool sensitivity,specificity with their 95% confidence intervals(CIs)for a summary piont,hierarchical summary receiver operator characteristic curves(HSROC)model to estimate summary receiver operating characteristics curve(SROC)for different cut-off values.Sensitivity analysis was applied to investigate how study design,patient characteristics are associated with test accuracy and meta-regression to find the source of heterogeneity.ResultsThree studies regarding gestational diabetes mellitus(GDM)were included in systematic review and other sixteen for Non-GDM in meta-analysis accounting for 12876 subjects in total.We found that the average cut-off values of GA reported for diagnosis of GDM is much lower than Non-GDM.For Non-GDM,we estimated the average location parameter Lambda 2.354(95%CIs 2.002,2.707),scale parameterβ is-0.163(95%CIs-0.614,0.288)through HSROC model.These studies had substantial heterogeneity and the type of DM,age,BMI may be possible heterogeneity sources.Circulating GA at cut-off of 14.0% had a summary sensitivity of 0.766(95% CIs 0.539,0.901)and a specificity of 0.687(95%CIs 0.364,0.894)for diagnosis of DM.The area under the curve(AUC)of the SROC was 0.80(95% CIs 0.76,0.83).ConclusionGA exhibited moderate diagnostic accuracy for diagnosis of Non-DM,and may be more accurate when combined with other assay for screening of DM.Researches regarding the diagnostic accurcy of GA for GDM and combinational measurement of GA should be done,as well as regarding unify and optimize GA detection methods. |
