CAJ | 학술논문

目的探讨血清糖基化终产物-肽(AGE-P)在社区糖尿病高危人群中的筛查价值.方法 2011年1至10月收集社区糖尿病高危人群857例,进行75 g口服葡萄糖耐量试验(OGTT),测定空腹血糖(FBG)、餐后2h血糖(2 hPG)及糖化血红蛋白(HbA1c),并留取血标本采用流动注射分析技术测定血清AGE-P值.利用受试者工作特征(ROC)曲线探讨血清AGE-P的筛查价值,并利用相关分析研究其与FBG、2 hPG、HbA1c等指标之间的相关性.结果 (1)根据2010年美国糖尿病协会糖尿病诊断标准,共筛选出糖尿病患者218例.(2)血清AGE-P诊断糖尿病的最佳切点为10.22 mg/L(峰值25.39 mm),敏感度为84.1％,特异度为88.3％；阳性预测值为71％.(3)血清AGE-P、FBG、2 hPG和HbA1c诊断糖尿病的ROC曲线下面积(AUC)分别为0.924、0.905、0.951和0.874;组间血清AGE-P与HbA1c比较,AUC值差异有统计学意义(P＜0.025)；血清AGE-P与FBG、2 hPG比较,AUC值差异均无统计学意义(均P＞0.025).(4)相关分析显示,血清AGE-P与HbA1c、FBG、2 hPG均呈正相关(均P＜0.05).结论血清AGE-P可用于社区糖尿病高危人群筛查,其筛查价值优于HbA1c.
목적 탐토혈청당기화종산물-태(AGE-P)재사구당뇨병고위인군중적사사개치.방법 2011년1지10월수집사구당뇨병고위인군857례,진행75 g구복포도당내량시험(OGTT),측정공복혈당(FBG)、찬후2h혈당(2 hPG)급당화혈홍단백(HbA1c),병류취혈표본채용류동주사분석기술측정혈청AGE-P치.이용수시자공작특정(ROC)곡선탐토혈청AGE-P적사사개치,병이용상관분석연구기여FBG、2 hPG、HbA1c등지표지간적상관성.결과 (1)근거2010년미국당뇨병협회당뇨병진단표준,공사선출당뇨병환자218례.(2)혈청AGE-P진단당뇨병적최가절점위10.22 mg/L(봉치25.39 mm),민감도위84.1％,특이도위88.3％；양성예측치위71％.(3)혈청AGE-P、FBG、2 hPG화HbA1c진단당뇨병적ROC곡선하면적(AUC)분별위0.924、0.905、0.951화0.874;조간혈청AGE-P여HbA1c비교,AUC치차이유통계학의의(P＜0.025)；혈청AGE-P여FBG、2 hPG비교,AUC치차이균무통계학의의(균P＞0.025).(4)상관분석현시,혈청AGE-P여HbA1c、FBG、2 hPG균정정상관(균P＜0.05).결론 혈청AGE-P가용우사구당뇨병고위인군사사,기사사개치우우HbA1c.
Objective To explore the value of serum advanced glycation end products-peptide (AGE-P) in the screening of diabetes mellitus in a community-based population of high-risk diabetics.Methods A total number of 857 adult high-risk diabetics from a community-based population underwent 75 g oral glucose tolerance test (OGTF).Blood samples were drawn to measure the levels of fasting blood glucose (FBG),postprandial blood glucose (2 hPG) and glycosylated hemoglobin A1c (HbA1c).And blood samples were also collected to determine the serum level of AGE-P with the technique of flow injection analysis.Receiver operating characteristic (ROC) curve was plotted to assess the screening value of serum AGE-P in diabetes mellitus.Pearson correlation analysis was conducted to evaluate the association between serum AGE-P and FBG,2 hPG,HbA1c,body mass index (BMI),waist-to-hip ratio (WHR) and age.Results Among them,218 adults were diagnosed with diabetes based on the 2010 American Diabetes Association (ADA) criteria.According to the ROC curve,the optimal cut-point of serum AGE-P for diagnosing diabetes was 10.22 mg/L (a peak height of 25.39 mm) with sensitivity of 84.1％,specificity of 88.3％ and positive predictive value of 71％.The area under curve (AUC) of serum AGE-P,FBG,2 hPG and HbA1c for diagnosing diabetes was 0.924,0.905,0.951 and 0.874 respectively.When comparing AUC between serum AGE-P and HbA1c,FBG and 2 hPG,statistical significance was only found in the comparisons between serum AGE-P and HbA1c (P ＜ 0.025).Pearson correlation analysis showed that serum AGE-P was highly positively correlated with HbA1c,significantly positively correlated with FBG and 2 hPG and slightly positively correlated with WHR and age (all P ＜ 0.05).But there was no correlation with BMI.Conclusions Serum AGE-P may be used for the screening of diabetes in the community-based population of high-risk diabetics.And it is even superior to HbA1c.