摘要
目的探讨糖化血红蛋白（HbAlc）用于诊断糖尿病的切点。方法对为明确DM诊断而初次就诊的高危人群739例进行口服葡萄糖耐量试验（OGTT），测定其空腹血糖（FPG）和服用75g葡萄糖2h后血糖（2hPG），同时测定HbAlc，根据WHO（1999年）糖代谢状态分类标准进行分组，研究人群糖耐量正常（NGT）61例，空腹血糖受损（IFG）46例，糖耐量减低（IGT）84例，糖调节受损（IGR）130例，糖尿病（DM）548例，通过受试者工作特征曲线（ROC曲线）分析，确定HbAlc用于诊断糖尿病的切点。结果NGT组的HbAlc为（5．7±0．6）％，DM组为（9．8±3．0）％，两者比较差异有统计学意义（t=10．7，P〈0．01）；如以FPG≥7．0mmol／L，或以2hPG≥11．1mmol／L，或以FPG≥7．0mmol／L且2hPG≥11．1mmol／L，或以FPG≥7．0mmol／L或2hPG≥11．1mmol／L作为诊断糖尿病的标准，HbAlc切点均为6．5％，曲线下面积（AUC）分别为0．981，0．980，0．990和0．973。结论高危人群糖尿病诊断的HbAlc切点为6．5％，HbAlc不适用于糖调节受损的诊断。
Objective To investigate hemoglobin Alc（HbAlc） cut points for the diagnosis of diabetes mellitus. Methods A total of 739 high-risk peoples were selected. All had fasting plasma glucose （FPG） and post 2h plasma glucose（2h PG） measurements after a 75 g load, HbAlc was examined at same time. According to World Health Organization [WHO] （1999） criteria,61 were normal glucose tolerance（NGT） ,46 had impaired fasting glucose （IFG） ,84 had impaired glucose tolerance （IGT）, 130 had impaired glucose regulation （IGR）, 548 patients had diabetes mellitus （DM）. Based on receiver operating characteristic curves,determine HbAlc cut points for the diagnosis of diabetes mellitus. Results The MeandzSD values of H bAIC in DM （9.8 ±3.0 %） was significantly greater than that in NGT （5.7%±0. 6 %）, （t= 10.7, P〈0. 01）. To identify diabetes based on four different criteria,the HbAlc cut point all were 6.5% ,and the areas under the curve （AUC） were 0. 981,0. 981,0. 991 and 0. 973,respectively. Conclusion The HbAlc cut point was 6.5% for the diagnosis of diabetes mellitus,but can＇t apply to the diagnosis of IGR.
出处
《现代检验医学杂志》
CAS
2012年第3期69-73,共5页
Journal of Modern Laboratory Medicine
关键词
糖化血红蛋白
糖尿病
糖调节受损
葡萄糖耐量试验
hemoglobin Alc
diabetes mellitus
impaired glucose regulation
oral glucose tolerance test
