中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2015年
4期
302-306
,共5页
糖尿病%血红蛋白A,糖基化%冠状动脉造影
糖尿病%血紅蛋白A,糖基化%冠狀動脈造影
당뇨병%혈홍단백A,당기화%관상동맥조영
Diabetes mellitus%Hemoglobin A,glycosylated%Coronary angiography
目的 比较1999年WHO(WHO 1999)和新版美国糖尿病学会(ADA)糖尿病诊断标准在中国非急性冠状动脉综合征患者中糖代谢异常检出的效果.方法 2013年10月至2014年4月期间,连续入选北京协和医院心内科拟行冠状动脉造影的非急性冠状动脉综合征患者,所有患者既往无明确糖尿病病史.根据冠状动脉造影前的空腹血糖(FPG)、75 g口服葡萄糖耐量试验糖负荷后2h血糖(2hPG)以及糖化血红蛋白(HbA1c)的结果,分别采用WHO 1999和新版ADA标准对患者进行糖代谢状态评估,并进行对比.结果 本研究共纳入139例患者(男88例,占63.3％),年龄(61.9±10.1)岁.根据WHO 1999标准,正常血糖34例(24.4％),糖尿病前期57例(41.0％),其中空腹血糖受损1例、糖耐量减低56例,新诊断糖尿病48例(34.5％);根据新版ADA标准,正常血糖14例(10.1％),糖尿病前期69例(49.6％),糖尿病56例(40.3％);在糖代谢异常的诊断中,相对于新版ADA标准,WHO 1999标准将遗漏12例糖尿病前期和8例糖尿病患者.与根据WHO 1999标准诊断的48例糖尿病患者相比,这8例依赖HbA1c水平诊断的患者,女性比例较高,且具有较低的血红蛋白[(124.88±17.74)g/L比(140.15±15.17)g/L,P=0.013]及较高的纤维蛋白原[(3.47±0.41)g/L比(3.02±0.68) g/L,P=0.024]水平.结论 与WHO 1999诊断标准相比,新版ADA标准可以发现额外的糖代谢异常患者.对于进行择期冠状动脉造影的患者,应考虑常规行HbA1c检测筛查糖代谢异常.
目的 比較1999年WHO(WHO 1999)和新版美國糖尿病學會(ADA)糖尿病診斷標準在中國非急性冠狀動脈綜閤徵患者中糖代謝異常檢齣的效果.方法 2013年10月至2014年4月期間,連續入選北京協和醫院心內科擬行冠狀動脈造影的非急性冠狀動脈綜閤徵患者,所有患者既往無明確糖尿病病史.根據冠狀動脈造影前的空腹血糖(FPG)、75 g口服葡萄糖耐量試驗糖負荷後2h血糖(2hPG)以及糖化血紅蛋白(HbA1c)的結果,分彆採用WHO 1999和新版ADA標準對患者進行糖代謝狀態評估,併進行對比.結果 本研究共納入139例患者(男88例,佔63.3％),年齡(61.9±10.1)歲.根據WHO 1999標準,正常血糖34例(24.4％),糖尿病前期57例(41.0％),其中空腹血糖受損1例、糖耐量減低56例,新診斷糖尿病48例(34.5％);根據新版ADA標準,正常血糖14例(10.1％),糖尿病前期69例(49.6％),糖尿病56例(40.3％);在糖代謝異常的診斷中,相對于新版ADA標準,WHO 1999標準將遺漏12例糖尿病前期和8例糖尿病患者.與根據WHO 1999標準診斷的48例糖尿病患者相比,這8例依賴HbA1c水平診斷的患者,女性比例較高,且具有較低的血紅蛋白[(124.88±17.74)g/L比(140.15±15.17)g/L,P=0.013]及較高的纖維蛋白原[(3.47±0.41)g/L比(3.02±0.68) g/L,P=0.024]水平.結論 與WHO 1999診斷標準相比,新版ADA標準可以髮現額外的糖代謝異常患者.對于進行擇期冠狀動脈造影的患者,應攷慮常規行HbA1c檢測篩查糖代謝異常.
목적 비교1999년WHO(WHO 1999)화신판미국당뇨병학회(ADA)당뇨병진단표준재중국비급성관상동맥종합정환자중당대사이상검출적효과.방법 2013년10월지2014년4월기간,련속입선북경협화의원심내과의행관상동맥조영적비급성관상동맥종합정환자,소유환자기왕무명학당뇨병병사.근거관상동맥조영전적공복혈당(FPG)、75 g구복포도당내량시험당부하후2h혈당(2hPG)이급당화혈홍단백(HbA1c)적결과,분별채용WHO 1999화신판ADA표준대환자진행당대사상태평고,병진행대비.결과 본연구공납입139례환자(남88례,점63.3％),년령(61.9±10.1)세.근거WHO 1999표준,정상혈당34례(24.4％),당뇨병전기57례(41.0％),기중공복혈당수손1례、당내량감저56례,신진단당뇨병48례(34.5％);근거신판ADA표준,정상혈당14례(10.1％),당뇨병전기69례(49.6％),당뇨병56례(40.3％);재당대사이상적진단중,상대우신판ADA표준,WHO 1999표준장유루12례당뇨병전기화8례당뇨병환자.여근거WHO 1999표준진단적48례당뇨병환자상비,저8례의뢰HbA1c수평진단적환자,녀성비례교고,차구유교저적혈홍단백[(124.88±17.74)g/L비(140.15±15.17)g/L,P=0.013]급교고적섬유단백원[(3.47±0.41)g/L비(3.02±0.68) g/L,P=0.024]수평.결론 여WHO 1999진단표준상비,신판ADA표준가이발현액외적당대사이상환자.대우진행택기관상동맥조영적환자,응고필상규행HbA1c검측사사당대사이상.
Objective Glycosylated hemoglobin A1c (HbA1c) has become one of key components in new American Diabetes Association (ADA) diagnostic criteria for pre-diabetes and diabetes,which is not included in the World Health Organization (WHO) 1999 criteria.Thus,we aimed to compare the two criteria in diagnosis of pre-diabetes and diabetes in patients with non-acute coronary syndrome (non-ACS) in Chinese.Methods Non-ACS patients who had undergone elective coronary angiography (CAG) in Peking Union Medical College Hospital without previously known diabetes were enrolled consecutively from October 2013 to April 2014.Fasting plasma glucose (FPG),2-hour plasma glucose after a 75 g oral glucose load (2hPG) and HbA1c levels before CAG were measured.Both WHO and new ADA criteria were applied for pre-diabetes and diabetes screening.Results One hundred and thirty-nine patients were included,aged (61.9 ± 10.1) years and 88(63.3％) were men among them.According to WHO 1999 criteria,34 patients (24.4％) were normal glucose regulation,57 (41.0％) pre-diabetes (including one impaired fasting glucose and 56 impaired glucose tolerance),and 48 (34.5％) newly diagnosed diabetes mellitus.ADA criteria identified 12 more patients with pre-diabetes and eight more with diabetes than WHO criteria.Compared with those diagnosed by both criteria,the proportion of women was higher in diabetic patients diagnosed with HbA1c alone.They also had lower hemoglobin [(124.88 ± 17.74) g/L vs (140.15 ± 15.17) g/L,P =0.013] and higher fibrinogen levels [(3.47 ± 0.41) g/L vs (3.02 ± 0.68) g/L,P =0.024] than those diagnosed by both criteria.Conclusion Compared with WHO 1999,new ADA criteria with HbA1c assessment are able to identify more previously unknown pre-diabetes and diabetes patients.Measurement of HbA1c might be needed to carry out routinely for screening patients with glucose metabolism abnormalities before elective CAG.
