糖尿病高风险人群糖化血红蛋白与微血管并发症的关系

Relationship between HbA1c and microvascular complications in high-risk populations of diabetes

目的 探讨在广州地区的糖尿病高风险人群中HbA1c与糖尿病微血管并发症之间的关系，并评价其对糖尿病的诊断价值。方法对208例糖尿病高风险患者进行HbA1c血精、眼底彩色照相及微量白蛋白尿测定。以受试者工作特征（ROC）曲线比较HbA1c、空腹血糖（FPG）、餐后2hm糖（2hPG）的诊断效果。结果高风险人群中糖尿病视网膜病变患病率为14．9％，微量白赁白尿患病率为12％HbA1c、FPG和2hPG分别为5．8％、7．0mmol／L和10．9mmol／L时视网膜病变的发病率显著增加：HbA1c FPG和2hPG分别为5．8％、6．4mmol／L和107mmol／L时微量白蛋白尿发病率明显增加：结论HbA1c为5．8％时糖尿病高风险人群微血管并发症患病率显著增加，HbA1c和2hPG判断做血管并发症的效果尤明显差异。FPG相对偏低。

Objective To explore the association of HbA1c with microvascular complicatinns,and to evaluate the diagnostic value of HbA1c in diabetes mellitus in high-risk populations of Guangzhou. Methods HbA1c, blood glucose, fundus photography, and microalbuminuria were detected in 208 permanent residents with high-risk factors of diabetes. The receiver operating characteristic（ROC） curves were used to estimate the area of HbA1c, fasting plasma glucose （ FPG ） , postprandial 2 h plasma glucose （ 2hPG ） under the crone for discriminating nficrovascular complications. Results There were 14.9% adults suffering from diabetic retinopathy and 12% microalbuminuria in high risk populations of diabetes. The optimal cutoff points of HbA1c, FPG, and 2hPG in detecting retinopathy were 5.8c/c ,7.0 retool/L, and 10.9 mmol/L respectively. The thresholds for increasing prevalence of microalbuminuria were 5.8% for HbA,： ,6.4 mmol/L for FPG, and 10.7 mmol/L fnr 2hPG. Conclusions The prevalence of diabetic microvascular complications increases dramatically at the concentration of HDA1c 5.8%. As a diagnostic value for microvascular complications, there is no significant difference between HbA1c and 2hPG.