摘要
目的对糖化血红蛋白(HbA1c)在体检中的应用及糖尿病前期管理的初步探索研究。方法选取2024年1-8月期间在宜昌市疾病预防控制中心进行了健康体检的315例体检者作为研究对象,依据年龄、性别分组进行HbA1c水平及异常率比较;纳入315例体检者的空腹血糖(FPG)水平和HbA1c水平进行了相关性分析与FPG水平和HbA1c水平对糖尿病及糖尿病前期诊出率比较;筛查出糖尿病前期体检人员(110例)中自愿参与第2次体检人员(61例)前后两次实验室检查结果进行比较;将全部315例体检人员按复查后数据分为正常组别(NG)192例、糖尿病前期组(pre-DM)104例、糖尿病组(DM)19例,进行各组基本信息及生化指标结果比较;使用FPG水平和葡萄糖耐量试验(OGTT)2 h水平对糖尿病前期(56例)分型,依据分型结果进一步进行风险评估并给出建议。使用深圳迈瑞BS-430全自动生化分析仪及其配套试剂进行检测全部生化指标,使用爱科来HA-8180全自动糖化血红蛋白分析仪及其配套试剂进行检测HbA1c。结果315例体检者随着年龄的增高FPG和HbA1c水平及异常率均增高,并均在60~<70岁组达峰后下降,男性较女性的FPG和HbA1c水平及异常率均增高,差异有统计学意义(P<0.05);相关性分析回归结果提示潜在异常值(6例)剔除前(n=315)后(n=309)FPG水平(Y)和HbA1c(X),水平之间均存在线性关系,回归方程分别为:Y=-0.797+1.080 X(R 2=0.488,P<0.05)、Y=-0.006+0.936X(R 2=0.473,P<0.05);HbA1c水平较FPG水平对糖尿病及糖尿病前期诊出率高,且对糖尿病前期诊出率差异有统计学意义(P<0.05);自愿参与第2次体检的糖尿病前期人员(61例)第2次检测的FPG和HbA1c水平均升高且差异均有统计学意义(P<0.05);NG组、pre-DM组、DM组相比,性别构成与身高差异均无统计学意义(P>0.05),年龄、体重、体重指数(BMI)、FPG、HbA1c、三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)各组间比较,差异均有统计学意义(P<0.05)。结论在健康体检人群中,HbA1c对糖尿病及糖尿病前期诊出率高于FPG,且对糖尿病前期的筛查明显优于FPG,将HbA1c运用于健康体检与糖尿病前期管理有着重要意义。
Objective To explore the application of glycated hemoglobin(HbA1c)in physical examinations and the preliminary management of prediabetes.Methods A total of 315 individuals who underwent health examinations at the Yichang Center for Disease Control and Prevention from January 2024 to August 2024 were selected as the research subjects.HbA1c levels and abnormal rates were compared based on age and gender groups.The correlation analysis of fasting plasma glucose(FPG)level and HbA1c level of 315 physical examinees was carried out,and the comparison of FPG level and HbA1c level on the detection rate of diabetes and pre diabetes was made.The results of two laboratory examinations before and after the second physical examination(61 cases)were compared among 110 pre diabetes physical examinees(110 cases)who volunteered to participate in the second physical examination.All 315 physical examination personnel were divided into normal group(NG)192 cases,pre diabetes group(pre DM)104 cases,and diabetes group(DM)19 cases according to the rechecked data,and the basic information and biochemical indicators of each group were compared;The FPG level and Oral Glucose Tolerance Test(OGTT)2 h level were used to classify the pre diabetes(56 cases),and further risk assessment and suggestions were made according to the classification results.Results The FPG and HbA1c levels and abnormal rates of the 315 examinees increased with age,and both peaked in the 60-<70 age group before declining.Males had higher FPG and HbA1c levels and abnormal rates than females,with statistically significant differences(P<0.05).Correlation analysis regression results indicated that before and after excluding potential outliers(6 cases)(n=315,then n=309),there was a linear relationship between FPG levels(Y)and HbA1c(X),with regression equations:Y=-0.797+1.080 X(R 2=0.488,P<0.05),Y=-0.006+0.936 X(R 2=0.473,P<0.05).HbA1c level was higher in the diagnosis of diabetes and prediabetes than FPG level,and the difference in the diagnosis rate of prediabetes was statistically significant(P<0.05).The FPG and HbA1c levels of the prediabetes personnel(61 cases)who voluntarily participated in the second examination were both elevated,and the differences were statistically significant(P<0.05).Compared among the NG group,pre-DM group,and DM group,there were no statistically significant differences in gender composition and height(P>0.05),while age,weight,body mass index(BMI),FPG,HbA1c,triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)showed statistically significant differences among the groups(P<0.05).Conclusion In the population of health examinations,HbA1c has a higher diagnostic rate for diabetes and prediabetes than FPG,and it is significantly better for screening prediabetes than FPG.The application of HbA1c in health examinations and the management of prediabetes is of great importance.
作者
徐珊
易森蓉
姚倩兰
孙凤英
杜胤
XU Shan;YI Senrong;YAO Qianlan;SUN Fengying;DU Yin(Department of Health Inspection Institute,Yichang Center for Disease Control and Prevention,Yichang,Hubei 443000,China)
出处
《国际检验医学杂志》
2025年第S2期18-25,共8页
International Journal of Laboratory Medicine
基金
湖北省自然科学基金项目(2024AFD131)。
