摘要
目的探讨糖化血红蛋白(HbA1c)作为糖尿病(DM)诊断标准,对2型DM高危人群DM确诊的敏感度、特异度和准确度及其诊断DM切点的确定。方法对334例2型DM高危人群,同一天检测其HbA1c和75g-口服葡萄糖耐量试验(OGTT)。按1999年WHO的DM诊断标准,得出其HbA1c累计频率分布表,绘制受试者工作特征曲线(ROC曲线)。结果以OGTT作为DM诊断"金标准",334例2型DM高危人群中,138例确诊DM;HbA1c≥6.5%者160例。分析其HbA1c的ROC曲线,HbA1c诊断DM最佳切点为6.5%,敏感度83.3%、特异度77.0%、阳性预测值71.9%、阴性预测值86.8%、准确度79.6%。HbA1c≥6.5%和空腹血糖≥7.0mmol/L、2h血糖≥11.1mmol/L各自单独作为诊断标准,判断结果并不完全一致。结论 HbA1c是一项较稳定的反映血糖水平的生物学指标,HbA1c≥6.5%可作为DM诊断标准之一。
Objective To investigate the glycated hemoglobin（HbA1c） as a diagnostic criteria for diabetes mellitus（DM） and determine the cut-off point of HbA1c level and its sensitivity,specificity and accuracy in a population at high risk for type 2 diabetes.Methods OGTT was performed and HbA1c was measured in 334 subjects at high risk for type 2 diabetes on the same day.According to WHO diagnostic criteria of DM in 1999,the cumulative frequency distribution was acquired and the receiver operating characteristic（ROC） curve was generated.Results Among 334 subjects,138 cases of diabetes were diagnosed by OGTT and 160 cases by HbA1c ≥ 6.5 %.The ROC curve analysis showed the best cut-off point of HbA1c level was ≥ 6.5% for DM diagnosis and the sensitivity was 83.3%,the specificity was 77.0%,the positive predictive value was 71.9%,the negative predictive value was 86.8%,the accuracy was 79.6%.The HbA1c testing and the OGTT did not reach full concordance.Conclusion HbA1c level is a stable biological parameter to reflect blood glucose level.Our study supports that HbA1c≥6.5% can serve as one of the type 2 diabetes diagnostic criteria.
出处
《福建医科大学学报》
2011年第5期371-373,380,共4页
Journal of Fujian Medical University
基金
福建省高校新世纪优秀人才计划资助项目(NCETFJ-0710)
