摘要
目的评价糖化血红蛋白(HbA1c)在疑似糖尿病患者中诊断糖尿病(DM)的应用价值及其诊断切点。方法研究对象来自2011年1～12月来笔者医院健康体检疑似糖尿病患者,共计1108名,男性636例,女性472例,年龄31～93岁(62.7±13.2岁)。研究对象行空腹口服葡萄糖耐量试验(OGTT)并同时测定HbA1c。按1999年世界卫生组织糖尿病诊断标准,以OGTT作为诊断DM的金标准。结果 1108例疑似DM患者中诊断为DM的患者298例(26.9%),空腹血糖受损(IFG)及糖耐量受损(IGT)患者428例(38.6%),正常糖代谢者382(34.5%)。受试者特征工作曲线分析显示,HbAlc诊断DM的曲线下面积(AUC)为0.881(95%CI:0.861～0.900),与空腹血糖(FPG)诊断DM的AUC为0.899(95%CI:0.880～0.916)无显著性差异(P=0.205)。以HbAlc≥6.2%为切点诊断DM的灵敏度为79.2%,显著高于FPG≥7.0mmol/L的65.8%和HbA1c≥6.5%的67.4%。结论在无法采用FPG或OGTT诊断DM时,HbA1c可用于DM的诊断;HbA1c≥6.2%是比较适合的DM诊断切点。
Objective To evaluate the clinical value of haemoglobin Ale （HbA1c） for diagnosing diabetic mellitus （DM） and i- dentify the optimal HbA1 c threshold in suspected patients with DM. Methods A total of 1108 subjects who were suspected of having dia- betes in an annual health check - up program in our hospital, including 636 males and 472 females,with a age range of 31 - 93 years （mean age： 62.7±13.2 years） , were enrolled in the present study from January 2011 to December 2011. All the subjects underwent oral glucose tolerance test （OGTT） , and the HbA1c were measured simultaneously. Based on the diabetes diagnosis criteria of WHO （1999） , the OGTT as gold standard was used for diagnosing diabetes. Results The 1108 subjects were diagnosed and divided into normal glucose tolerance group（ n = 382, 34.5% ） , and impaired fasting glucose （IFG） with impaired glucose tolerance （IGT） （ n = 428, 38.6% ） , and DM group（n = 298, 26.9% ）. Analysis by Receiver operator characteristic curve for diabetes diagnosis, showed that the area under the curve （AUC） was 0. 881 of HbA1 c （95% CI： 0. 861 - 0. 900） , which was equivalent to that of fasting blood glucose （FPG） （ AUC ： 0. 899, 95% CI： 0. 880-0. 9160, P =0. 205）. The sensitivity of using HbA1c≥6.2% （79.2%） as the diabetes diagnosis criterion was significantly higher than using FPG≥ 7.0 mmol/L （65.8%） or HbA1 c ≥ 6.5% （67.4%）. Conclusion HbA1 c measurement is suitable for diabetes diagnosis when FPG or OGTT is not available. An HbA1c threshold of 6.2% is an optimal cut -off point for diabetes diagnosis.
出处
《医学研究杂志》
2012年第12期140-143,共4页
Journal of Medical Research
关键词
口服葡萄糖耐量试验
糖化血红蛋白
空腹血糖
受试者工作曲线
Oral glucose tolerance test
Hemoglobin Alc
Fasting plasma glucose
Receiver operator characteristic curve
