体检人群糖化血红蛋白水平在不同性别和年龄的诊断价值

Value of Glycosylated Hemoglobin A1c Level and Gender and Age Stratification in People Undergoing Physical Examination

目的分析宜宾地区糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbA1c)水平与性别和年龄间的关系,探讨性别和年龄对糖尿病(diabetes mellitus,DM)的筛查和诊断价值。方法回顾性研究,横断面调查,收集2017年6月~2018年3月的体检者1 510例,按年龄分为6组。应用日本爱科来(Arkray HA-8180型)全自动糖化血红蛋白分析仪检测,分析不同性别和年龄组HbA1c水平的差异,探讨HbA1c与年龄、性别之间的关系与规律,计算糖尿病的患病率。两组间比较采用两组独立样本资料t检验,组间两两比较采用LSD-T检验。分析不同分析标准对结果的影响。结果随着年龄增加,HbA1c水平增加明显。在41~50岁年龄段,男性(6.15%±1.59%)明显高于女性(5.66%±0.99%),男女之间比较差异有统计学意义(P<0.05);在患病率的比较中,男性的患病率在41~50岁较31~40岁有明显的增加,从5.92%增加到21.09%,女性患病率的年龄段明显增加则是在51~60岁,从8.16%增加到23.62%,在70岁以下人群的年龄段中,男女均有差异。在总人群的统计中,糖尿病的患病率超过了16%,高危人群达到了23.31%。结论 HbA1c的水平与年龄、性别均有关,不同性别人群HbA1c水平呈现随年龄增大而逐渐增高的趋势,其筛查糖尿病的准确性随着年龄的增加而降低,这对于糖尿病患者的诊治和前期患者的筛查都有重要的意义。

Objective To study the distribution of glycosylated hemoglobin Alc（HbA1 c）levels in the region,understand the relationship among HbA1 clevel and gender and age,and investigate the clinical value of diagnostic and screening DM from heath physical examination groups on HbA1 c.Methods Retrospective and cross-sectional study,1 510 cases of physical examination individuals from July 2017 to March 2018 were retrospectively collected.Age was further divided into six groups.HbA1 cwas measured by ARKRAY HA-8180 automatic glycosylated hemoglobin analyzer（Japan）.All data were collected for analyzing the HbA1 clevels in different sex and age groups,exploring the rule between HbA1 cand age,calculated diabetes morbidity.Differences between the two groups were compared using the independent samples t test.The comparison between two groups was performed with LSD-Ttest,and compared the different diagnostic criteria of diabetes mellitus（DM）.Results Increased with age,HbA1 csignificantly increased.Between the ages of 41 and 50,men（6.15% ±1.59%）were significantly higher than women（5.66%±0.99%）.The difference between men and women was statistically significant（P〈0.05）.In the prevalence comparison,the prevalence rate of men aged 41-50 was significantly higher than that of men aged 31-40,which was increased from 5.92%to 21.09%.A significant increase in the age group of women was between 51 and 60,which was changed from 8.16%to 23.62%.There was also a difference between men and women in the age group before the age of 70.The prevalence of diabetes was more than 16 percent in the general population,and 23.32 percent in the high-risk population.Conclusion HbA1 clevel was related to age and gender.HbA1 clevel had gradually risen with increasing age.The accuracy of HbA1 cfor detecting undiagnosed diabetes decreased with increasing age.It is a great significance for the diagnosis and treatment of DM and also for the screening and intervention of Pre-diabetes（PreD）patients.