糖化血红蛋白联合糖化血清白蛋白检测在糖尿病筛查中的价值

The Value of Glycosylated Hemoglobin Combined With Glycosylated Serum Albumin in Screening Diabetes

目的分析糖化血红蛋白(glycated hemoglobin,HbA1c)、糖化血清白蛋白(glycatedAlbumin,GA)联合检测在糖尿病(diabetes mellitus,DM)筛查中的价值。方法选取邵东市中医医院2020年2月—2022年2月明确诊断DM而就诊者和糖尿病高危人群接受DM筛查共120例,男性67例,女性53例,检测研究对象的HbA1c、GA水平,分析HbA1c、GA在糖尿病筛查中的价值。结果(1)研究对象空腹血糖为(6.11±0.66)mmol/L;0.5 hPG、1 hPG、2 hPG、3 hPG分别为(9.84±0.36)mmol/L、(11.25±0.69)mmol/L、(9.74±0.58)mmol/L、(6.80±0.25)mmol/L;GA为(17.45±0.55)%,HbA1c为(6.34±0.45)%。女性的年龄空腹血糖、0.5 hPG、1 hPG、2 hPG、HbA1c、GA均低于男性(P<0.05)。经OGTT试验诊断为DM患者54例,占45.00%;诊断为糖耐量正常(normal glucose tolerance,NGT)的患者36例,占30.00%;诊断为糖调节受损(impaired sugar regulation,IGR)的患者30例,占25.00%。(2)NGT组、IGR组、DM组的HbA1c、GA水平比较,差异有统计学意义(P<0.05),且DM组的HbA1c、GA水平高于NGT组、IGR组(P<0.05)。(3)GA的AUC、敏感度、特异度分别为0.811、96.67%、75.00%;HbA1c的AUC、敏感度、特异度分别为0.717、70.00%、69.44%;联合检测的受试者工作特征曲线(receiver operating characteristic curve,ROC)曲线下的面积(area under curve,AUC)、敏感度、特异度分别为1.000、100%、100%,联合诊断的敏感度与特异度较高。结论HbA1c、GA联合检测在糖尿病筛查中具有较高的应用价值。此文的研究结果为糖尿病筛查的后期标准制定提供了借鉴内容。

Objective To analyze the value of combined detection of glycosylated hemoglobin(HbA1c)and glycosylated serum albumin(GA)in screening diabetes mellitus(DM).Methods From February 2020 to February 2022 in Shaodong Hospital of Traditional Chinese Medicine,a total of 120 patients and highrisk groups of diabetes were screened for DM,including 67 males and 53 females.The HbA1c and GA levels of the subjects were detected,and the value of HbA1c and GA in diabetes screening was analyzed.Results(1)The fasting blood glucose of the study subjects was(6.11±0.66)mmol/L;0.5 hPG,1 hPG,2 hPG,and 3 hPG were(9.84±0.36)mmol/L,(11.25±0.69)mmol/L,(9.74±0.58)mmol/L and(6.80±0.25)mmol/L,respectively.GA was(17.45±0.55)%and HbA1c was(6.34±0.45)%.The age,fasting blood glucose,0.5 hPG,1 hPG,2 hPG,HbA1c,and GA of women were lower than those of men(P<0.05).54 patients(45.00%)were diagnosed with DM through OGTT test.There were 36 patients diagnosed with normal glucose tolerance(NGT),accounting for 30.00%.There were 30 patients diagnosed with impaired sugar regulation(IGR),accounting for 25.00%.(2)The levels of HbA1c and GA in NGT group,IGR group and DM group were significantly different(P<0.05),and the HbA1c and GA levels in the DM group were higher than those in the NGT and IGR groups(P<0.05).(3)The AUC,sensitivity and specificity of GA were 0.811,96.67%,and 75.00%,respectively,while the AUC,sensitivity,and specificity of HbA1c were 0.717,70.00%,and 69.44%,respectively.The area under curve(AUC),sensitivity,and specificity under the receiver operating characteristic curve(ROC)of the combined detection subjects were 1.000,100%,and 100%,respectively,indicating a higher sensitivity and specificity for combined diagnosis.Conclusion The combined detection of HbA1c and GA has high application value in diabetes screening.The results of this study provide a reference for the later standard formulation of diabetes screening.