摘要
目的评价糖尿病危险积分(DRS)对糖尿病(DM)一线筛查的价值。方法 259例既往未诊断DM的受试人群进行问卷调查和查体,分别计算芬兰DRS(F-DRS)和中国DRS(C-DRS),间隔2~3周重复进行两次OGTT。结果两次OGTT结果显示为正常、IFG或IGT、IFG合并IGT、DM组的F-DRS和C-DRS分别为5.6521±4.53和13.97±9.84、7.60±3.85和20.59±8.87、8.90±3.77和23.07±8.56、11.67±5.05和26.31±7.87(P<0.05).ROC曲线显示F-DRS切点为9时,以单次OGTT结果和两次OGTT结果评价的敏感性分别为63.8%和67.3%,特异性为60.8%和62.7%,若敏感性达到85%时的切点分别为6.0和6.5;C-DRS切点为18时,以单次OGTT结果和两次OGTT结果评价的敏感性分别为83.0%和85.5%,特异性为49.1%和51.0%,敏感性达到85%时的切点均为19.5。对F-DRS≥9的人群再进行OGTT检测DM的诊断率为67%,33%患者漏诊,而49%的非DM患者可以免做OGTT。对C-DRS≥18的人群再进行OGTT检测DM的诊断率达85%,15%患者漏诊,而39%的非DM患者免做OGTT。结论DRS与IGT程度具有很好的一致性;C-DRS比F-DRS敏感性更高,更适合于中国人群DM的一线筛查。
Objective To evaluate the role of Diabetes Risk Score (DRS) as the initial instrument for screening diabetes mellitus (DM). Methods The Finnish DRS (F-DRS) and Chinese DRS (C-DRS) were calculated based on a simple self-administered questionnaire completed by Chinese individuals without a history of diabetes (male 152, female 107) who underwent two oral glucose tolerance tests (OGTT) over a period of 2-3 weeks. Results The two tests of OGTT showed significant prevalence(%) differences between F-DRS and CDRS (all P〈0. 05)in NGT [(5. 65±4. 53) vs (13. 97±9.84)],in IFG or IGT[(7. 60±3. 85) vs (20. 59± 8. 87)%,in IFG plus IGT [(8. 90±3. 77) vs (23. 07±8. 56)],and in DM [(11.67±5.05) vs (26. 31±7. 87)1. The ROC showed that, with a cutoff of 9, the sensitivities of F-DRS in detecting DM by one and two OGTTs were 63. 8% and 67. 3% respectively, the specificity 60. 8% and 62. 7% ; at sensitivity o[ 85% with the cutoffs of 6. 0 and 6. 5. With a cutoff of 18, the sensitivity of C-DRS in detecting DM by one and two OGTTs was 83. 0% and 85.5%, the specificity 49.1% and 51.0% respectively; at sensitivity of 85% with the cutoffs of 19. 5 and 19. 5. The use of the F-DRS and C-DRS followed by the OGTT may lead to the identification of 67% and 85% of DM, with undetection rate of 33 % and 15% respectively. Conclusions The DRS is in concordance with OGTT-diagnosed glucose metabolism categories. Compared with F-DRS, C-DRS represents a more sensitive and suitable method for screening DM in China.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2009年第3期201-204,共4页
Chinese Journal of Diabetes
关键词
口服葡萄糖耐量试验
糖尿病危险积分
糖调节受损
糖尿病
ROC曲线
Oral glucose tolerance test
Diabetes Risk Score
Impaired glucose regulation
Diabetes mellitus
Receiver-operating characteristic curve