CAJ | 학술논문

目的探索2010年美国糖尿病协会(ADA)推荐的糖尿病前期HbA1C诊断标准在中国青少年人群中的适用性.方法随机抽取辽阳市初中和高中学生933人(13～16岁,女性46.5%),测定HbA1C和空腹血糖,对HbA1C5.7%～6.4%的部分受试者进行口服葡萄糖耐量试验(OGTT),以受试者工作特性(ROC)曲线评价HbA1C对糖尿病前期的诊断价值.结果符合ADA 2010年推荐的糖尿病前期诊断标准者213人,其中同时符合HbA1C和空腹血糖标准者仅占4.7%.HbA1C诊断空腹血糖升高的ROC曲线下面积为0.50(P=0.97).由HbA1C标准诊断糖尿病前期并行OGTF的68人中18人确定为糖耐量受损或空腹血糖受损,HbA1C诊断糖尿病前期的ROC曲线下面积为0.53(P=0.69).结论在中国青少年人群中HbA1C不宜作为糖尿病前期的诊断方法.
목적 탐색2010년미국당뇨병협회(ADA)추천적당뇨병전기HbA1C진단표준재중국청소년인군중적괄용성.방법 수궤추취료양시초중화고중학생933인(13～16세,녀성46.5%),측정HbA1C화공복혈당,대HbA1C5.7%～6.4%적부분수시자진행구복포도당내량시험(OGTT),이수시자공작특성(ROC)곡선평개HbA1C대당뇨병전기적진단개치.결과 부합ADA 2010년추천적당뇨병전기진단표준자213인,기중동시부합HbA1C화공복혈당표준자부점4.7%.HbA1C진단공복혈당승고적ROC곡선하면적위0.50(P=0.97).유HbA1C표준진단당뇨병전기병행OGTF적68인중18인학정위당내량수손혹공복혈당수손,HbA1C진단당뇨병전기적ROC곡선하면적위0.53(P=0.69).결론 재중국청소년인군중HbA1C불의작위당뇨병전기적진단방법.
Objective To evaluate the performance of HbA1C in diagnosis of pre-diabetes in Chinese adolescents.Methods A total of 933 students(aged 13-16 year,46.5% female)without known history of diabetes were selected from junior and senior middle schools in Liaoyang city.HbA1C and fasting plasma glucose(FPG)levels were determined in all participants.Pre-diabetes was diagnosed as according to 2010 American Diabetes Association (ADA)criteria[HbA1C 5.7%-6.4%,FPG(5.6-6.9)mmol/L].The individuals with HbA1C ≥5.7% underwent oral glucose tolerance test(OGTT)and were classified into impaired glucose tolerance(IGT)and impaired fasting glucose(IFG)according to 1999 World Health Organization(WHO)criteria.The performance of HbA1C in diagnosing pre-diabetes by the new criteria was evaluated by the traditional OGTT results based on receiver operating characteristic(ROC)curves.Results Among all participants,213(22.8%)individuals were diagnosed as prediabetic subjects.72.3% of individuals with pre-diabetes were identified by HbA1C alone,23.0% by FPG alone,and only 4.7% by both tests simultaneously.The ROC curve for HbA1C to identify impaired fasting glucose diagnosed by new criteria had an area under the curve(AUC)of 0.50 without statistical significance(P = 0.97).Of the 164 participants with HbA1C 5.7% -6.4%,68 individuals received OGTT,among which 18 subjects were diagnosed as IGT(n= 14)or IFG(n = 4).The ROC curve for HbA1C to identify pre-diabetes diagnosed by OGTT had an AUC of 0.53,without statistical significance(P = 0.69).Conclusion In Chinese adolescents,HbA1C is not suitable for diagnosis or screening of pre-diabetes.