糖尿病三种不同诊断标准异同的探讨

An Exploration of Three Diagnostic Criteria for Diabetes Mellitus

目的 :探讨世界卫生组织 (WHO)、美国糖尿病学会 (ADA)以及以往运用较为广泛的兰州会议这三个糖尿病诊断标准的异同。方法 :对 1997年至 2 0 0 0年体检发现空腹血糖 (FPG)≥ 6 .1mmol/L和部分空腹血糖正常者共2 34例 ,做口服葡萄糖耐量试验 (OGTT) ,按WHO、ADA以及兰州会议诊断标准划分不同的血糖水平人群 ,并比较分析人群分布异同 ,同时对各诊断标准划分的糖尿病人群的FPG、餐后 2h血糖 (PG2h)的频数分布进行比较。结果 :WHO与兰州会议标准诊断糖尿病 (DM )人群的分布频数几乎一样 ,FPG≥ 7.0mmol/L者近 6 5 % ,而FPG≥ 7.8mmol/L者仅占 45 %。兰州会议标准诊断DM组PG2h≥ 11.1mmol/L者占 85 %以上 ,ADA标准诊断DM组PG2h≥ 11.1mmol/L者在 75 %以上。与WHO标准比较 ,兰州会议标准组的符合率正常人群 10 0 %、DM 87.5 % ,而ADA标准组的符合率NGT6 4.71%、DM 80 %。与ADA标准比较 ,兰州会议标准组的符合率NGT6 2 .0 7%、DM 6 2 .5 0 % ;WHO标准组的符合率NGT5 6 .41% ,DM 6 2 .75 %。兰州会议标准组的NGT无一例被WHO或ADA标准诊为DM ,以WHO、ADA标准诊断的NGT或正常人群正常空腹血糖 (NFG)者各有 8例被对方诊断为DM ,占该人群的 10 %～ 12 %。结论 :诊断DM时将FPG的标准由原≥ 7.8mmol/L降至≥ 7.

Objective: To explore the difference of diagnostic crietia for diabetes which were made by WHO,American Ciabetes Association(ADA),and LanZhou Meeting(LZM),respectively.Methods: 234 examinees for health checkup received 75 g of standard oral gluscose tolerance test(OGTT),prior to the test,the fasting plasma glucose(FPG)of most examinees was≥6.1 mmol/L,while the other’s was normal.Results: The distribute frequency of FPG in the examinees who were diagnosed as diabetes according to the criteria of LZM was similar to that of according to the criteria of WHO.The coincidence between the crietia of LZM and WHO was 100% in normal glucose test(NGT)and 87.5% in diabetes mellitus (DM),while the coincidence between the crietia of WHO and ADA was 64.71% in NGT and 80% in DM.The coincidece between the criteria of LZM and ADA was 62.07% in NGTand 62.50% in DM,while the coincidence between criteria of WHO and ADA was 56.41% in NGTand 62.75% in DM.Conclusion: For the diagnosis of DM,it was certain that as criteria of FPG lowered from≥7.8 mmol/L to ≥7.0 mmol/L,it would increase the coincidence with PG2 h ≥11.1 mmol/L,But they didn’t entirely coincide.The crietia of LZM were more coincided with those of WHO,Therefore,we think that the diagnostic crietia of LZM is still valuable in clinical practice.