CAJ | 학술논문

探讨HbA1C和空腹血糖(FPG)在社区人群糖尿病筛查中的应用价值.对上海市杨浦区2个街道社区流行病学调查中的1 794名居民行口服葡萄糖耐量试验(OGTT),并检测HbA1C,根据世界卫生组织1999年糖尿病诊断标准,筛查出正常糖耐量(NGT)、空腹血糖受损(IFG)、糖耐量受损(IGT)、IFG合并IGT和糖尿病分别为1 411、111、73、33和166例.采用受试者工作特征(ROC)曲线判断,与诊断糖尿病相关的FPG最佳切点为6.15 mmol/L,敏感性和特异性分别为89.0%和92.8%,曲线下面积为0.959;与诊断糖尿病相关的HbA1C最佳切点为6.5%,敏感性和特异性分别为71.1%和80.2%,曲线下面积为0.822;以FPG≥6.1 mmol/L且HbA1C≥6.5%筛查糖尿病,其敏感性和特异性分别为66.9%和97.0%;以FPG≥16.1mmol/L或HbA1C≥6.5%筛查糖尿病,其敏感性和特异性分别为96.3%和76.7%.研究结果提示空腹血糖和HbA1C在社区糖尿病的筛查诊断中均有很好的价值,联合应用可提高诊断率.
탐토HbA1C화공복혈당(FPG)재사구인군당뇨병사사중적응용개치.대상해시양포구2개가도사구류행병학조사중적1 794명거민행구복포도당내량시험(OGTT),병검측HbA1C,근거세계위생조직1999년당뇨병진단표준,사사출정상당내량(NGT)、공복혈당수손(IFG)、당내량수손(IGT)、IFG합병IGT화당뇨병분별위1 411、111、73、33화166례.채용수시자공작특정(ROC)곡선판단,여진단당뇨병상관적FPG최가절점위6.15 mmol/L,민감성화특이성분별위89.0%화92.8%,곡선하면적위0.959;여진단당뇨병상관적HbA1C최가절점위6.5%,민감성화특이성분별위71.1%화80.2%,곡선하면적위0.822;이FPG≥6.1 mmol/L차HbA1C≥6.5%사사당뇨병,기민감성화특이성분별위66.9%화97.0%;이FPG≥16.1mmol/L혹HbA1C≥6.5%사사당뇨병,기민감성화특이성분별위96.3%화76.7%.연구결과제시공복혈당화HbA1C재사구당뇨병적사사진단중균유흔호적개치,연합응용가제고진단솔.
The validity of HbA1C and fasting plasma glucose(FPG)for screening of diabetes in community population was investigated.A total of 1 794 subjects from two sub-districts of Yangpu District,Shanghai,underwent a 75 goral glucose tolerance test(OGTT)and HbA1C determination.Based on 1999 World Health Organization criteria,there were 1 411 subjects with normal glucose tolerance(NGT),111 impaired fasting glucose(IFG),73 impaired glucose tolerance(IGT),33 IFG+IGT,and 166 diabetes.According to the receiver operating characteristic curve,the optimal cut-point of FPG for diagnosing diabetes was 6.15 mmol/L with sensitivity of 89.0%,specificity of 92.8%,and area under the curve of 0.959.The cut-point of HbA1C for diagnosing diabetes was 6.5% with a sensitivity and specificity of 71.1% and 80.2%.The area under the curve was 0.822.The screening model using FPG ≥6.1mmol/L and HbA1C≥6.5% had sensitivity of 66.9% and specificity of 97.0%.When the model was FPG ≥6.1 mmol/L or HbA1C ≥6.5%,the sensitivity and specificity was 96.3% and 76.7% respectively.The results suggest that both FPG and HbA1C have good value for screening diabetes in community,and FPG combined with HbA1C may further promote diagnostic efficacy.