中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2010年
10期
1174-1178
,共5页
张云良%郭淑芹%马文彬%王君%白广芹%杨茜%提素芳%马锐%魏瑞璞%刘文宣%李哲%杨磊%刘殿武%李志红
張雲良%郭淑芹%馬文彬%王君%白廣芹%楊茜%提素芳%馬銳%魏瑞璞%劉文宣%李哲%楊磊%劉殿武%李誌紅
장운량%곽숙근%마문빈%왕군%백엄근%양천%제소방%마예%위서박%류문선%리철%양뢰%류전무%리지홍
糖尿病%空腹血糖受损%糖耐量低减%指尖毛细血管空腹血糖%切点
糖尿病%空腹血糖受損%糖耐量低減%指尖毛細血管空腹血糖%切點
당뇨병%공복혈당수손%당내량저감%지첨모세혈관공복혈당%절점
Diabetes mellitus%Impaired fasting glucose%Impaired glucose tolerance%Fingertip capillary blood glucose%Cut-off point
目的 探讨指尖毛细血管空腹血糖(指尖FPG)筛检社区45岁以上人群糖尿病和糖尿病前期[空腹血糖受损(IFG)、糖耐量低减(IGT)]的切点,为人群普查提供依据.方法 随机整群抽取保定市3个社区,以社区内45岁以上居民3250人为筛查对象.对指尖FPG≥5.1 mmol/L者进行75 g口服葡萄糖耐量试验(OGTT),测空腹血糖及服糖2 h静脉血浆血糖(2hPG),诊断糖尿病和糖尿病前期.应用受试者工作(ROC)曲线确定糖尿病及IFG、IGT的切点,判断诊断价值.结果 检出糖尿病230例(7.3%),IFG 166例(5.2%),IGT 204例(6.7%);以指尖FPG为测试变量,以是否FPG≥7.0 mmol/L及或2hPG≥11.1 mmol/L为说明变量ROC曲线分析,曲线下面积为0.905,最佳切点为6.0 mmol/L,最大灵敏度和特异度分别是78.0%和89.3%;以是否FPG<5.6 mmol/L、是否FPG<7.0 mmol/L及7.8 mmol/L≤2hPG≤11.1 mmol/L为说明变量ROC曲线分析,曲线下面积分别为0.633、0.719,最佳切点均为5.7 mmol/L,灵敏度和特异度均较低(50.3%、28.0%;60.8%、28.0%).结论 用指尖FPG 6.0mmol/L为切点筛查45岁以上人群糖尿病,相对可靠;但指尖FPG筛查IFG、IGT不可靠.指尖FPG筛查社区人群简便、快捷,有一定的应用意义.
目的 探討指尖毛細血管空腹血糖(指尖FPG)篩檢社區45歲以上人群糖尿病和糖尿病前期[空腹血糖受損(IFG)、糖耐量低減(IGT)]的切點,為人群普查提供依據.方法 隨機整群抽取保定市3箇社區,以社區內45歲以上居民3250人為篩查對象.對指尖FPG≥5.1 mmol/L者進行75 g口服葡萄糖耐量試驗(OGTT),測空腹血糖及服糖2 h靜脈血漿血糖(2hPG),診斷糖尿病和糖尿病前期.應用受試者工作(ROC)麯線確定糖尿病及IFG、IGT的切點,判斷診斷價值.結果 檢齣糖尿病230例(7.3%),IFG 166例(5.2%),IGT 204例(6.7%);以指尖FPG為測試變量,以是否FPG≥7.0 mmol/L及或2hPG≥11.1 mmol/L為說明變量ROC麯線分析,麯線下麵積為0.905,最佳切點為6.0 mmol/L,最大靈敏度和特異度分彆是78.0%和89.3%;以是否FPG<5.6 mmol/L、是否FPG<7.0 mmol/L及7.8 mmol/L≤2hPG≤11.1 mmol/L為說明變量ROC麯線分析,麯線下麵積分彆為0.633、0.719,最佳切點均為5.7 mmol/L,靈敏度和特異度均較低(50.3%、28.0%;60.8%、28.0%).結論 用指尖FPG 6.0mmol/L為切點篩查45歲以上人群糖尿病,相對可靠;但指尖FPG篩查IFG、IGT不可靠.指尖FPG篩查社區人群簡便、快捷,有一定的應用意義.
목적 탐토지첨모세혈관공복혈당(지첨FPG)사검사구45세이상인군당뇨병화당뇨병전기[공복혈당수손(IFG)、당내량저감(IGT)]적절점,위인군보사제공의거.방법 수궤정군추취보정시3개사구,이사구내45세이상거민3250인위사사대상.대지첨FPG≥5.1 mmol/L자진행75 g구복포도당내량시험(OGTT),측공복혈당급복당2 h정맥혈장혈당(2hPG),진단당뇨병화당뇨병전기.응용수시자공작(ROC)곡선학정당뇨병급IFG、IGT적절점,판단진단개치.결과 검출당뇨병230례(7.3%),IFG 166례(5.2%),IGT 204례(6.7%);이지첨FPG위측시변량,이시부FPG≥7.0 mmol/L급혹2hPG≥11.1 mmol/L위설명변량ROC곡선분석,곡선하면적위0.905,최가절점위6.0 mmol/L,최대령민도화특이도분별시78.0%화89.3%;이시부FPG<5.6 mmol/L、시부FPG<7.0 mmol/L급7.8 mmol/L≤2hPG≤11.1 mmol/L위설명변량ROC곡선분석,곡선하면적분별위0.633、0.719,최가절점균위5.7 mmol/L,령민도화특이도균교저(50.3%、28.0%;60.8%、28.0%).결론 용지첨FPG 6.0mmol/L위절점사사45세이상인군당뇨병,상대가고;단지첨FPG사사IFG、IGT불가고.지첨FPG사사사구인군간편、쾌첩,유일정적응용의의.
Objective To determine the efficient cut-off points of fasting fingertip blood glucose test for undiagnosed diabetes mellitus(DM), impaired glucose tolerance(IGT), and impaired fasting glucose(IFG)in community-based residents aged above 45 years old. Methods A cluster-randomized study was conducted from May 2008 to January 2009. A total of 3250 subjects aged above 45 years in two communities of Baoding city received questionnaire investigation and tested for fingertip blood glucose. Those subjects whose capillary blood glucose level ≥5.1 mmol/L were subjected to 75 g oral glucose tolerance test. Undiagnosed diabetes mellitus and pre- diabetes were identified by fasting plasma glucose and OGTT. In this study, the cut-off points of fasting capillary blood glucose for detecting undiagnosed diabetes and pre-diabetes were evaluated, using receiver operator characteristic curve(ROC). Results Of 1351 subjects that having had oral glucose tolerance test, 230 cases were diagnosed as diabetes mellitus(7.3%), 166 cases(5.2%)as IFG, and 204(6.7%)as IGT under fasting capillary blood glucose as test variable and state variables according to the following criteria.(1)FPG≥7.0 mmol/L or/and 2hPG≥11.1 mmol/L(2)FPG<5.6 mmol/L (3)FPG<7.0 mmol/L and 7.8 mmol/L≤2hPG≤ 11.1 mmol/L, areas under three ROC curves were 0.905, 0.633 and 0.719, respectively. The cut-offvalues of screening for undiagnosed DM, IGT and IFG were 6.0 mmol/L, 5.7 mmol/L, and 5.7 mmol/L, respectively. When cut-off value of screening for undiagnosed DM was 6.0 mmol/L, the maximal sensitivity was 78.0% and specificity was 89.3%.But there were both lower sensitivity and specificity in screening for IFG and IGT according to the best predicting value(5.7 mmol/L)from the ROC curves(50.3% and 28.0% vs. 60.8% and 28.0%). Conclusion Fasting capillary blood glucose with the lower cut-point of 6.0 mmol/L in screening for undiagnosed diabetes mellitus alone, was relatively reliable, whereas for both IFG and IGT the fasting fingertip blood glucose tests were fallible. It was convenient and could be used in screening the DM at the community level.
