糖化血红蛋白对广州地区人群糖尿病前期的筛查价值

Values of glycosylated hemoglobin in screening for patients with prediabetic state in Guangzhou region

目的探讨糖化血红蛋白对广州地区人群糖尿病前期的筛查价值。方法选择525例健康体检的广州人,进行口服葡萄糖耐量试验(OGTT),并采用BIO-RAD D-10型全自动糖化血红蛋白分析仪检测GHbA1c,以OGTT结果为诊断标准,通过受试者工作特征(ROC)曲线分析获得GHbA1c诊断葡萄糖调节受损(IGR)的最佳临界值。结果 GHbA1c诊断IGR的最佳临界值为5.95%,GHbA1c≥5.95%和GHbA1c≥5.7%诊断IGR时的敏感性分别为53.3%、84.8%,特异性分别为72.8%、31.0%。GHbA1c≥5.95%及FPG≥5.6mmol/L联合诊断IGR的敏感性与单独GHbA1c≥5.7%的差异性无统计学意义(P=0.406),而特异性明显升高(P=0.000)。结论 GHbA1c≥5.7%可用于糖尿病前期的筛查但不宜用于诊断。GHbA1c≥5.95%与FPG≥5.6mmol/L联合可在广州人中有效筛查糖尿病前期患者。

Objective To study the values of glycosylated hemoglobin in screening for patients with prediabetic state in Guang-zhou region .Methods 525 Guangzhou people who had accepted health examination were enrolled and were subjected to oral glucose tolerance test（OGTT） .BIO-RAD D-10 automatic glycosylated hemoglobin analyzer was employed to detect their glycosylated he-moglobin A1c（GHbA1c） .OGTT results were served as diagnostic criteria ,Receiver operator characteristic （ROC） curve analysis was performed to obtain the optimal threshold of GHbA1c in diagnosing impaired glucose regulation （IGR） .Results The optimal threshold of GHbA1c in diagnosing IGR was 5 .95% .The sensitivities of GHbA1c≥5 .95% and GHbA1c≥5 .7% in diagnosing IGR were 53 .3% and 84 .8% ,respectively ,while their specificities were 72 .8% and 31 .0% ,respectively .The difference of sensitivity between GHbA1c≥5 .95% combined with FPG≥5 .6 mmol/L and GHbA1c≥5 .7% alone in diagnosing IGR showed no statistical significance（P= 0 .406） ,while the specificity increased obviously （P= 0 .000） .Conclusion The criteria of GHbA1c≥5 .7% can be used for prediabetic state screening but not for diagnosis .GHbA1c≥5 .95% combined with FPG≥5 .6 mmol/L can be used effectively for prediabetic state screening in Guangzhou people .