CAJ | 학술논문

目的探讨研究糖化血红蛋白(HbAlc)与糖调节受损血糖水平的相关性.方法 2009年2-3月在兰州大学附属白银医院在岗职工中开展口服75 g葡萄糖耐量试验(OGTT)和HbAlc普查,测定空腹血糖、服糖后2 h血糖及HbAlc,采用葡萄糖氧化酶法测定静脉血浆血糖,采用高效液相色谱分析法测定HbAlc.研究资料纳入标准:空腹血糖<7.0 mmol/L且服糖后2 h血糖<11.1mmol/L者,无糖尿病、血红蛋白病、肝、肾疾患等.进入结果分析的对象共726例,男197例,女529例,平均年龄(39±10)岁.其中正常糖耐量636例(87.6%),糖调节受损90例(12.4%),糖调节受损诊断采用1999年世界卫生组织糖尿病诊断标准.率间比较采用χ~2检验,双变量分析采用Pearson相关分析.结果 (1)糖调节受损占HbAlc≤5.7%人群的2.3%,占HbAlc≥5.8%的人群中89.3%.HbAlc≥5.8%时预测OGTT诊断的糖调节受损状态的敏感度、特异度、阳性预测值、阴性预测值分别为83%、99%、0.89和0.98;(2)OGTT诊断的空腹血糖受损、糖耐量减低及糖调节受损状态的患病率,在HbAlc为5.8%组与5.7%组比较差异具有统计学意义(χ~2值分别为10.077、22.219和27.780,P<0.01或P<0.001);(3)HbAlc水平与空腹血糖受损、糖耐量减低、糖调节受损的患病率之间呈显著性正相关(r值分别为0.957、0.928和0.936,均P<0.01).结论 (1)HbAlc预测糖调节受损与OGTT具有一致性,与OGTT诊断的糖调节受损状态相关的HbAlc最佳临界值为5.8%;(2)HbAlc与OGTT诊断空腹血糖受损、糖耐量减低、糖调节受损状态的血糖水平呈显著性正相关,且HbAlc为5.8%与其相关性极其密切.建议当HbAlc≥5.8%时均应行OGTY检查,以明确有无糖调节受损.
목적 탐토연구당화혈홍단백(HbAlc)여당조절수손혈당수평적상관성.방법 2009년2-3월재란주대학부속백은의원재강직공중개전구복75 g포도당내량시험(OGTT)화HbAlc보사,측정공복혈당、복당후2 h혈당급HbAlc,채용포도당양화매법측정정맥혈장혈당,채용고효액상색보분석법측정HbAlc.연구자료납입표준:공복혈당<7.0 mmol/L차복당후2 h혈당<11.1mmol/L자,무당뇨병、혈홍단백병、간、신질환등.진입결과분석적대상공726례,남197례,녀529례,평균년령(39±10)세.기중정상당내량636례(87.6%),당조절수손90례(12.4%),당조절수손진단채용1999년세계위생조직당뇨병진단표준.솔간비교채용χ~2검험,쌍변량분석채용Pearson상관분석.결과 (1)당조절수손점HbAlc≤5.7%인군적2.3%,점HbAlc≥5.8%적인군중89.3%.HbAlc≥5.8%시예측OGTT진단적당조절수손상태적민감도、특이도、양성예측치、음성예측치분별위83%、99%、0.89화0.98;(2)OGTT진단적공복혈당수손、당내량감저급당조절수손상태적환병솔,재HbAlc위5.8%조여5.7%조비교차이구유통계학의의(χ~2치분별위10.077、22.219화27.780,P<0.01혹P<0.001);(3)HbAlc수평여공복혈당수손、당내량감저、당조절수손적환병솔지간정현저성정상관(r치분별위0.957、0.928화0.936,균P<0.01).결론 (1)HbAlc예측당조절수손여OGTT구유일치성,여OGTT진단적당조절수손상태상관적HbAlc최가림계치위5.8%;(2)HbAlc여OGTT진단공복혈당수손、당내량감저、당조절수손상태적혈당수평정현저성정상관,차HbAlc위5.8%여기상관성겁기밀절.건의당HbAlc≥5.8%시균응행OGTY검사,이명학유무당조절수손.
Objective To investigate the correlation of glycosylated hemoglobin (HbAlc) and impaired glucose regulation(IGR). Methods Seventy-five g oral glucose tolerance test(OGTT)and HbAlc levels were carried out among our hospital staffs. The subjects were determined fasting plasma glucose (FPG), oral glucose 2 h plasma glucose(2 h PG)and HbAlc, plasma glucose levels and HbAlc levels were determined by glucose oxidase method and high performance liquid chromatogram ( HPLC). The inclusion criteria of subjects was FPG<7.0 mmol/L and 2 h PG<11.1 mmol/L, without diabetes, hemoglobin disease, hepatopathy and renopathy. The selected object contained 726 subjects (197 male, 529 female, mean age (39±10)), including NGT 636 subjects(87.6% ) , IGR 90 subjects( 12.4% ). The diagnostic criteria of IGR selected 1999 WHO diagnostic criteria for diabetes. χ~2 test was used for rate comparison. Pearson correlation analysis was used for bivariate analysis selected. Results (1)2.3% occurred IGR among HbAlc≤5.7% subjects, while 89. 3% occurred IGR among HbAlc≥5.8% subjects. When HbAlc ≥5.8% ,the sensibility, specificity, PV + , and PV - were 83% , 99% , 0.89, 0.98, respectively. (2) Between HbAlc level 5.8% group and HbAlc 5.7% group, the difference of prevalence of the OGTT diagnosed IFG,IGT,IGR had statistically significance(χ~2 value was 10. 077,22. 219 and 27. 780, P<0.01 or P<0.001), (3) HbAlc levels was significant positive correlation with the prevalence of IFG,IGT,IGR(rralue was 0.957,0.928 and 0.936, all P<0.01).Conclusions (1) Compared with OGTT, HbAlc had consistency for predicting IGR, and the optimal critical value of HbAlc with OGTT diagnosed IGR was 5.8%. (2) HbAlc levels was significant positive correlation with the blood sugar level of the OGTT diagnosed IFG, IGT, IGR, and when HbAlc =5.8%, its relevance is most closely. The present study suggests that the HbAlc ≥5.8% patients should be examined OGTT in order to identify whether the IGR.