摘要
目的根据ＷＨＯ糖尿病诊断和分类委员会近来提出的糖尿病新诊断标准中以空腹血糖（ＦＰＧ）≥７．０ｍｍｏｌ／Ｌ（≥１２６ｍｇ／ｄｌ）取代ＦＰＧ≥７．８ｍｍｏｌ／Ｌ（≥１４０ｍｇ／ｄｌ），为探讨我国糖尿病人群ＦＰＧ的诊断水平。方法对１９９４年全国２５岁以上２５万人群糖尿病普查中经口服７５ｇ葡萄糖耐量试验（ＯＧＴＴ）检查人群的资料进行了分析（其中新诊断２型糖尿病２３８０例、糖耐量低减３１０６例、ＯＧＴＴ正常７７２５例、共１３２１１例）。结果经ＦＰＧ分布频数发现，在新诊断糖尿病组中约５０％的人ＦＰＧ＜７．８ｍｍｏｌ／Ｌ。在该组经直线回归分析显示：与ＯＧＴＴ后２小时静脉血浆血糖（ＰＧ２ｈ）≥１１．１ｍｍｏｌ／Ｌ（≥２００ｍｇ／ｄｌ）相关最好的ＦＰＧ值是≥６．７ｍｍｏｌ／Ｌ（≥１２１ｍｇ／ｄｌ）（Ｐ＜０．０００１）。与ＷＨＯ提出的ＦＰＧ≥７．０ｍｍｏｌ／Ｌ非常接近。经检验ＦＰＧ≥７．０ｍｍｏｌ／Ｌ（≥１２６ｍｇ／ｄｌ）的特异性好于ＦＰＧ≥６．７ｍｍｏｌ／Ｌ（分别为９５％和９１％），敏感性好于ＦＰＧ≥７．８ｍｍｏｌ／Ｌ（分别为６７％和５３％），提示ＦＰＧ≥７．８ｍｍｏｌ／Ｌ不是一个灵敏的诊断指标。在总受检人群组１３２１１例经?
Objective According to the new diagnostic criteria (i e, fasting plasma glucose (FPG)≥7.0mmol/L(≥126mg/dl)) as suggested recently by the WHO expert committee on the diagnosis and classification of diabetes mellitus (DM), the diagnostic level of FPG in a Chinese diabetic population was explored. Methods From 250000 subjects, age≥25 years studied in a national DMepidemiologic surveyB Bin 1994, 13211 subjects who received 75g oral glucose tolerance test (OGTT) were analyzed, including 2380 subjects with newly diagnosed type 2 DM(NDM), 3106 subjects with impaired glucose tolerance (IGT) and 7725 subjects with normal glucose tolerance. Results The FPG distribution frequency in the NDM group showed that 50%of subjects had FPG<7.8mmol/L. Using linear regression model to compare the relation of FPG to 2 h plasma glucose after OGTT (PG2h) in NDM group, it was found that FPG correlating most to PG2h≥11.1mmol/L(≥200mg/dl) was≥6.7mmol/L(≥121mg/dl)(P<0.0001). ItwasquiteclosetoFPG≥7.0mmol/L as suggsted by WHO.ThespecificityinFPG≥7.0mmol/LwashigherthaninFPG≥6.7mmol/L (95% and 91% respectively) and the sensitivity in FPG≥7.0mmol/L was better than in FPG≥7.8mmol/L (67% and 53% respectively). Using multiple linear regression analysis to compare the relation of FPG to PG2h in the general subject group (n=13211), the FPG corresponding to PG2h<7.8mmol/L was <5.9 mmol/L(<107mg/dl). Conclusion FPG≥7.8mmol/L is not a sensitive diagnostic criterion of DM. FPG≥7mmol/L, due to its high specificity and better sensitivity than FPG≥7.8mmol/L, can be accepted as a diagnostic criterion of DM. At the same time, WHO suggests that FPG<6.1mmol/L as a dividing point between normal andIGTcancooperatewithPG2h<7.8mmol/L and is likewise suitable to the population in China.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
1998年第1期3-7,共5页
Chinese Journal of Endocrinology and Metabolism
