CAJ | 학술논문

目的：评估皖南地区人群HbA1c在糖尿病（ DM）诊断中的应用价值。方法：①2010年1月～2013年1月来我院内分泌科门诊为明确DM诊断而就诊者和DM高危人群接受DM筛查者共800名。空腹10 h行口服葡萄糖耐量试验（OGTT），测定空腹血糖（FPG）、糖负荷后2 h血糖（2 hPG）和糖化血红蛋白（HbAlc）；②根据世界卫生组织糖尿病诊断标准，将800名就诊者分为糖耐量正常（ NGT）组、糖调节受损（ IGR）组和DM组，分别为400例、150例和250例。按照ROC判断其HbAlc最佳切点。结果：NGT、IGR、DM组的HbAlc水平呈递增趋势（P＜0．05）。相关性分析显示，HbA1c与FPG、2 hPG均呈正相关。以HbAlc≥6．4％为切点诊断DM的敏感性，与以FPG≥7．0 mmol/L为诊断标准的结果基本相符，同时其约登指数均高于HbA1c≥6．3％和HbA1c≥6．5％切点的约登指数。结论： HbAlc可用于DM的诊断，HbAlc≥6．4％比较适合皖南地区人群的诊断DM的HbAlc切点。
목적：평고환남지구인군HbA1c재당뇨병（ DM）진단중적응용개치。방법：①2010년1월～2013년1월래아원내분비과문진위명학DM진단이취진자화DM고위인군접수DM사사자공800명。공복10 h행구복포도당내량시험（OGTT），측정공복혈당（FPG）、당부하후2 h혈당（2 hPG）화당화혈홍단백（HbAlc）；②근거세계위생조직당뇨병진단표준，장800명취진자분위당내량정상（ NGT）조、당조절수손（ IGR）조화DM조，분별위400례、150례화250례。안조ROC판단기HbAlc최가절점。결과：NGT、IGR、DM조적HbAlc수평정체증추세（P＜0．05）。상관성분석현시，HbA1c여FPG、2 hPG균정정상관。이HbAlc≥6．4％위절점진단DM적민감성，여이FPG≥7．0 mmol/L위진단표준적결과기본상부，동시기약등지수균고우HbA1c≥6．3％화HbA1c≥6．5％절점적약등지수。결론： HbAlc가용우DM적진단，HbAlc≥6．4％비교괄합환남지구인군적진단DM적HbAlc절점。
Objective:To assess the value of hemoglobin A1c test(HbA1c) in diagnosis of diabetes mellitus(DM) in population from south Anhui areas. Methods:A total of 800 patients with either final diagnosis of DM or high risks of DM undergone screening test in our department were included between January 2010 and January 2013.All patients underwent oral glucose tolerance test(OGTT) and measurement of fasting plasma glucose(FPG),2 h post-load plasma glucose(2 hPG) and HbAlc,and were allocated to normal glucose tolerance group(NGT,n=400),impaired glucose regulation group (IGR, n=150) and DM group(n=250) in compliance with the diagnostic criteria published by WHO.The receiver operating characteristic (ROC) curve was used estimate the optimal cut-off point.Results:HbAlc level was elevated in groups of NGT,IGR and DM(P<0.05).Correlation analysis demonstrated that HbA1c was positively correlated with FPG and 2 hPG.The sensitivity of using HbAlc≥6.4% as the diabetes diagnostic criteria was consistent with WHO cutoff of FPG≥7.0 mmol/L.Simultaneously,the Youden index of HbAlc≥6.4% was higher than that of HbA1c≥6.3% and HbA1c≥6.5%,re-spectively.Conclusion:HbAlc can be applicable to diagnosis of DM,and HbA1c value of 6.4% may serve as an optimal cutoff of FPG in estimation of the DM in population from south Anhui areas.