ADA及WHO糖尿病诊断标准在中国人中检出率的变化及迁移

The changes and shifts of the diagnosis sensitivity for diabetes in Chinese subjects based on ADA and WHO diabetes diagnostic criteria

目的 比较美国糖尿病协会１９９７年修订的糖尿病诊断标准［ＡＤＡ（１９９７）］和世界卫生组织糖尿病诊断标准［ＷＨＯ（１９８０～１９８５）］在中国人中检出率的变化及迁移。方法 对９０６例研究对象实施７５ｇ 口服葡萄糖耐量试验（ＯＧＴＴ）。结果 ＡＤＡ（１９９７）空腹血糖（ＦＰＧ）标准较ＷＨＯ（１９８０～１９８５）标准敏感性提高１１．１５％ ，并使近１／５的糖尿病（ＤＭ）患者可免于ＯＧＴＴ而被确诊，但仍有近半数经ＷＨＯ（１９８０～１９８５）标准诊断的ＤＭ 患者被ＡＤＡ（１９９７）ＦＰＧ标准诊断为空腹血糖损害（ＩＦＧ）或正常空腹血糖者（ＮＦＧ）。结论 对用ＡＤＡ（１９９７）ＦＰＧ标准诊断为ＩＦＧ及ＮＦＧ，尤其是存在糖尿病高危因素者，有必要进行ＯＧＴＴ２小时血糖核查。

Objective To compare the impact of the 1997 American Diabetes Association(ADA) versus the 1980～1985 World Health Organization (WHO) diagnostic criteria for diabetes mellitus on diagnosis sensitivity.Methods 906 Chinese subjects who received 75g standard oral glucose tolerance test(OGTT) were analyzed.Results The sensitivity of ADA(1997) fasting plasma glucose (FPG) criteria for diabetes was 11 15% higher than WHO(1980～1985) FPG criteria. About one fifth diabetic subjects were diagnosed without OGTT, but nearly one half diabetic subjects who were diagnosed by WHO criteria were diagnosed as impaired fasting glucose (IFG) or normal fasting glucose (NFG) by ADA (1997) FPG criteria.Conclusion It may be necessary to examine OGTT 2h plasma glucose for those subjects diagnosed as IFG and NFG by ADA (1997) FPG criteria, especially in individuals with high diabetic risk factors.