Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population

BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.

Persistently High Glycated Hemoglobin in a Subgroup of Type 2 Diabetic Patients Who Failed Usual Oral Antihyperglycemics and Insulin in Côte d’Ivoire

Background: Type II diabetes mellitus is associated with multiple metabolic derangements which can cause secondary pathophysiological changes in multiple organ systems. This in turn can impose a heavy burden of morbidity and mortality from micro‑ and macro‑vascular complications. This study aimed to describe the metabolic and therapeutic profile of a subgroup of type 2 diabetic patients who have treatment failure with oral anti-hyperglycemic agents with persistent hyperglycemia despite insulin treatment. Methods: 60 type 2 diabetic patients in treatment failure with oral antidiabetics and under insulin treatment, aged 35 to 70 years, were recruited at the Diabetes Clinic of the University Teaching Hospital of Treichville in Abidjan, Côte d’Ivoire. Blood samples were collected in tubes containing Ethylenediaminetetraacetic Acid (EDTA) to determine glycated hemoglobin (HbA1c). Results: The average age of the population was 54 ± 9.38 years with a sex ratio (M/F) of 0.3, an average BMI of 30.25 ± 5 kg/m2, and an average HbA1c of 10.1% ± 1.6% for an average diabetes duration of 11.8 ± 5.8 years. The average insulin dose was 74.556 ± 16.21 UI/day, and the average duration of insulin treatment was 5.4 ± 3.1 years. The average HbA1c value was 10.1% ± 1.87% in men against 10.03% ± 1.53% in women with no significant difference (p = 0.1). The mean HbA1c values according to patient weight were 10.08% ± 2.05% for normal weight, 9.55% ± 2.26% for overweight, and 10.57% for obese, with no significant difference between the three groups of patients (p = 0.1). Conclusion: This study showed a persistence increase in glycated hemoglobin regardless of the treatment regimen, duration, and dose of insulin treatment in the subpopulation of type 2 diabetic patients.

血清C肽与糖化血红蛋白联合检验对糖尿病患者辅助诊断的价值

目的探讨血清C肽与糖化血红蛋白诊断糖尿病的价值。方法选取厦门大学附属第一医院杏林分院于2021年1月—2023年12月收治的200例疑似糖尿病患者为研究对象,均检测C肽与糖化血红蛋白水平,以糖耐量试验为金标准,分析两项指标联合的诊断价值。结果糖耐量试验结果显示,200例疑似患者中确诊糖尿病165例,非糖尿病35例;血清C肽联合糖化血红蛋白检查的检出率为83.50%,高于单一指标的72.50%、74.50%。联合诊断糖尿病的准确度、灵敏度、阴性预测值高于单一指标,差异有统计学意义(P均<0.05)。结论糖尿病诊断时,血清C肽联合糖化血红蛋白可发挥确切价值。

Elevation of the glycated albumin to glycated hemoglobin ratio during the progression of hepatitis C virus related liver fibrosis

AIM: To analyze the relationship between the glycated albumin (GA) to glycated hemoglobin (HbA1c) ratio and the histological grading of liver fibrosis.METHODS: The study retrospectively included consecutive hepatitis C virus positive chronic liver disease patients (n = 142) who had undergone percutaneous liver biopsy between January 2008 and March 2010 at our institution. The ratios of GA/HbA1c were calculated in all patients to investigate the relationship with the degree of the liver fibrosis. The values of the aspartate aminotransferase-to-platelet ratio index (APRI), an excellent marker for the evaluation of liver fibrosis, were also calculated. In addition, we combined the ratio of GA/HbA1c and the APRI in order to improve our ability to detect the presence of significant liver fibrosis. RESULTS: Sixty-one (43%) patients had either no fibrosis or minimal fibrosis (METAVIR score: F0-F1), while 25 (17%) had intermediate fibrosis (F2). Fifty-six (39%) patients had severe fibrosis (F3-F4) and 27 of them had cirrhosis (F4). The mean values of the GA/HbA1c increased with the progression of the fibrosis (F0-1: 2.83 ± 0.24, F2: 2.85 ± 0.24, F3: 2.92 ± 0.35, F4: 3.14 ± 0.54). There was a significant dif- ference between the F0-F1 vs F4, F2 vs F4, and F3 vs F4 groups (P < 0.01, P < 0.01, P < 0.01 and P < 0.05, respectively). The GA/HbA1c ratio was significantly higher in the patients with cirrhosis (F4) than in those without cirrhosis (F0-F3) (3.14 ± 0.54 vs 2.85 ± 0.28, P < 0.0001). The GA/HbA1c ratio was also significantly higher in the patients with severe fibrosis (F3-F4) than in those without severe liver fibrosis (F0-F2) (3.03 ± 0.41 vs 2.84 ± 0.24, P < 0.001). Furthermore, the GA/ HbA1c ratio was also significantly higher in the patients with significant fibrosis (F2-F4) than in those without significant liver fibrosis (F0-F1) (2.98 ± 0.41 vs 2.83 ± 0.24, P < 0.001). The diagnostic performance of the increased GA/HbA1c ratio (> 3.0) was as follows: its sensitivity and specificity for the detection of liver cirrhosis (F4) were 59.3% and 70.4%, respectively and its sensitivity and specificity for the detection of severe liver fibrosis (F3-F4) were 50.0% and 74.4%,respectively. With regard to the detection of significant fibrosis (F2-F4), its sensitivity was 44.4% and its specificity was 77.0%. Although even the excellent marker APRI shows low sensitivity (25.9%) for distinguishing patients with or without significant fibrosis, the combination of the APRI and GA/HbA1c ratio increased the sensitivity up to 42.0%, with only a modest decrease in the specificity (from 90.2% to 83.6%). CONCLUSION: The GA/HbA1c ratio increased in line with the histological severity of liver fibrosis, thus suggesting that this ratio is useful as a supportive index of liver fibrosis.

糖尿病肾病患者早期诊断中mAlb、HbA1c、Cys-C检测对早期肾损伤的评估研究

目的:探究糖尿病肾病患者早期诊断中尿微量白蛋白(mAlb)、糖化血红蛋白(HbA1c)、胱抑素C(Cys-C)检测对早期肾损伤的评估。方法:选取2021年7月至2022年12月江西省信丰县人民医院就诊的90例糖尿病患者为研究对象,其中单纯糖尿病记为甲组(30例)、早期肾损伤记为乙组(30例)、糖尿病肾病记为丙组(30例);同期健康体检者记为对照组(30例)。对比四组mAlb、HbA1c、Cys-C水平差异,四组mAlb、HbA1c、Cys-C阳性检出率,分析联合检测对糖尿病肾病预测价值。结果:甲、乙、丙3组mAlb、HbA1c、Cys-C水平均高于对照组(P<0.05);且丙组>乙组>甲组(P<0.05)。甲、乙、丙3组mAlb、HbA1c、Cys-C阳性率均高于对照组(P<0.05);且丙组>乙组>甲组(P<0.05)。经ROC曲线分析显示,mAlb、HbA1c、Cys-C联合检测AUC、敏感度、特异度均大于单项检测(P<0.05)。结论:mAlb、HbA1c、Cys-C联合检测能提高糖尿病肾病患者早期肾损伤阳性检出率,有利于反映早期肾损伤严重程度。

HGI、u-ALB及TNC与2型糖尿病视网膜病变的相关性研究

目的研究糖化血红蛋白变异指数(HGI)、尿微量白蛋白(u-ALB)及血清腱生蛋白C(TNC)与2型糖尿病视网膜病变(T2DR)的相关性。方法回顾性选择2021年4月至2023年5月于首都医科大学大兴教学医院接受治疗的2型糖尿病(T2DM)患者1390例的临床资料,根据T2DR发生情况将其分为T2DR组(n=378)和非T2DR组(n=1012)。依据糖尿病视网膜病变早期治疗研究分类系统对T2DR患者进行分期,分为非增殖期T2DR组(n=275)和增殖期T2DR(n=103)。观察两组基线资料(性别、年龄、T2DM病程)、血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、血脂[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇、甘油三酯]、HGI、u-ALB及血清TNC水平;观察不同T2DR病变分期患者基线资料、血糖、血脂、HGI、u-ALB、血清TNC水平。采用Pearson相关分析对T2DM患者HGI、u-ALB、血清TNC与T2DR的相关性进行分析。采用多因素Logistic回归分析对影响T2DR发生的独立危险因素进行分析。结果T2DR组与非T2DR组的性别构成比、年龄比较,差异均无统计学意义(P>0.05);T2DR组T2DM病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC水平均大于非T2DR组,差异均有统计学意义(P<0.05)。增殖期T2DR组与非增殖期T2DR组的性别构成比、年龄比较,差异均无统计学意义(P>0.05);增殖期T2DR组的T2DM病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC水平均大于非增殖期T2DR组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,HGI、u-ALB、TNC与T2DM患者发生T2DR呈正相关(P<0.05)。多因素Logistic回归分析结果显示,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素。结论HGI、u-ALB、TNC的异常升高可促进T2DM患者T2DR的发生及进展,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素。

探讨在糖尿病诊断中采用血清C肽以及糖化血红蛋白的效果

目的 探讨在糖尿病诊断中血清C肽以及糖化血红蛋白(Glycosylated Haemoglobin, HbA1c)的效果。方法 选取2022年1月—2023年5月联勤保障部队第910医院收治的96例糖尿病患者为糖尿病组,并选取接受体检的60名健康人员为对照组,均开展血清C肽与HbA1c检测,比较两组检测结果。结果 与对照组比较,糖尿病组血清C肽更低,HbA1c水平更高,差异有统计学意义(P均<0.05)。血清C肽联合HbA1c诊断糖尿病的准确率为87.18%,灵敏度为85.42%,特异度为90.00%。结论 糖尿病诊断中血清C肽以及HbA1c可取得较好的效果,同时可为糖尿病患者的病情评估提供参考价值。

血清C肽和糖化血红蛋白联合检验在2型糖尿病检测中的临床分析

目的分析血清C肽和糖化血红蛋白联合检验在2型糖尿病检测中的作用。方法回顾性选取厦门大学附属第一医院杏林分院于2021年1月—2023年12月收治的112例2型糖尿病患者及112名同期进行健康体检者的临床资料,两组均进行血清C肽和糖化血红蛋白水平的检测,对比两组血清C肽和糖化血红蛋白水平,计算并分析单项检测及联合检测的诊断效能。结果两组血清C肽和糖化血红蛋白水平对比,差异有统计学意义(P均<0.001);血清C肽真阳性86例,糖化血红蛋白真阳性89例,联合检测真阳性106例;联合检测的灵敏度、特异度、准确度分别为94.64%、91.96%、93.30%,均高于血清C肽和糖化血红蛋白单项检测,差异有统计学意义(P均<0.05)。结论糖化血红蛋白和血清C肽联合检验在2型糖尿病检测中具有较高灵敏度、特异度和准确度,能够提供更全面、准确信息,有助于早期发现、诊断和治疗糖尿病。

Development of Disposable Single-Use Biosensor for Fructosyl Valine and Glycated Hemoglobin A1c

A novel amperometric biosensor prototype was fabricated using screen printing technique. The disposable single-use strips were made from conductive carbon ink and modified with fructosyl amino acid oxidase. The electrodes and conducting paths were made solely with carbon ink and characterized by conductivity and cyclic voltammetry. The biosensor showed high current output, large linearity, and effectiveness for fructosyl valine as well as human blood samples. Amperometric studies were carried out using both fructosyl valine and human blood samples. With 5 uL sample volume, the biosensor showed strong amperometric response with good linearity for a wide range (0 to 8 mM). Diabetic and healthy blood samples showed sufficient difference in their amperometric responses that correlate well with their different hemoglobin A1c levels. These results demonstrate the feasibility of using this type of inexpensive single-use biosensor strips as the basis for determining hemoglobin A1c levels for diabetic patients.

血红蛋白糖化指数联合血清C肽在2型糖尿病诊断中的应用价值分析

目的分析血红蛋白糖化指数(hemoglobin glycation index,HGI)联合血清C肽(C-peptide,C-P)在2型糖尿病(type 2 diabetes mellitustype,T2DM)中的诊断价值。方法回顾性选取2022年1月—2024年1月连江县医院收治的100例T2DM患者及94名同期的健康受试者的临床资料,分别为T2DM患者组和健康受试者组。两组均进行HGI、C-P检测,分析单一及联合检测对T2DM的诊断价值。结果两组HGI、C-P水平比较,差异有统计学意义(P均<0.05)。联合检测的曲线下面积为0.917,高于其他单一指标,差异有统计学意义(P<0.05)。结论针对T2DM患者的诊断,HGI、C-P联合检测的应用价值更高。

2型糖尿病患者中血清C肽与糖化血红蛋白联合检测的诊断价值

目的综合分析2型糖尿病患者中血清C肽与糖化血红蛋白(Glycated Hemoglobin A1c,HbA1c)联合检验的诊断价值。方法选取泉州市中医院于2022年4月-2023年4月收治的80例疑似2型糖尿病患者为研究对象,以口服糖耐试验结果为金标准,分析血清C肽与HbA1c单一检测、联合检测的阳性检出结果、诊断效能(准确度、灵敏度、特异度)。结果口服糖耐量试验检出阳性69例,阴性11例;血清C肽单一检出真阳性54例,真阴性4例;HbA1c单一检出真阳性57例,真阴性6例;血清C肽与HbA1c联合检出真阳性66例,真阴性9例。血清C肽与HbA1c联合检测的准确度、灵敏度分别为93.75%、95.65%,均高于单一检测,差异有统计学意义(P均<0.05)。联合检测的特异度为81.82%,高于单一检测,但差异无统计学意义(P>0.05)。结论血清C肽与HbA1c是2型糖尿病临床诊断中价值较高的评估指标,其联合检测可以客观地评价患者的血糖水平,有助于对糖尿病的早期筛查、诊断,从而为后续治疗提供依据。

孕早期C反应蛋白、Gal-13和糖化血红蛋白对妊娠期糖尿病早期预测的价值分析

目的探讨在孕早期用C反应蛋白(CRP)、半乳糖凝集素-13(Gal-13)和糖化血红蛋白(HbA1c)预测妊娠期糖尿病的临床价值。方法回顾性分析2017年5月至2023年5月于西华县妇幼保健院门诊建档并产检的98例孕妇的临床资料,根据是否合并妊娠期糖尿病将其分为两组,观察组(48例)合并妊娠期糖尿病,对照组(50例)未合并妊娠期糖尿病,比较两组孕妇血清CRP、Gal-13、HbA1c水平,分析影响妊娠期糖尿病发生的危险因素,探究血清CRP、Gal-13、HbA1c对妊娠期糖尿病的预测价值。结果观察组BMI、CRP、HbA1c水平均高于对照组,Gal-13低于对照组,差异有统计学意义(P<0.05);CRP、HbA1c水平较高、Gal-13表达水平较低均为影响妊娠期糖尿病发病的因素(P<0.05);血清CRP、Gal-13、HbA1c联合检测妊娠期糖尿病受试者工作曲线下面积(AUC)值高于单项检测(Z=2.547、3.676、2.101,P<0.05)。结论血清CRP、Gal-13、HbA1c均为妊娠期糖尿病发病影响因素,均可作为妊娠期糖尿病的预测指标。

血清Cys-C、HbA1c和AcR对糖尿病肾病的早期诊断价值

目的探讨血清胱抑素C(Cys-C)、糖化血红蛋白(HbA1c)和尿微量白蛋白与肌酐比值(AcR)在早期糖尿病肾病(DN)诊断中的应用价值。方法选取2022年7月—2023年6月常熟市第一人民医院、常熟市第二人民医院、常熟市中医院的患者共135例,根据病理学诊断分组,其中糖尿病组82例,早期糖尿病肾病组53例;另选来自健康体检中心的健康对照组50例。观察比较三组中,血清Cys-C、HbA1c和AcR检测对糖尿病肾病的早期诊断价值。结果与糖尿病组、健康对照组对比,早期糖尿病肾病组血清Cys-C、HbA1c和AcR指标均明显增高,组间差异有统计学意义(P<0.05)。早期糖尿病肾病组Cys-C、HbA1c和AcR阳性率均高于糖尿病组和健康对照组,组间差异有统计学意义(P<0.05)。血清Cys-C、HbA1c和AcR检测诊断DN的敏感度分别为92.45%、88.68%、94.34%,准确率分别为95.14%、67.57%、90.81%,Kappa值分别为0.88、0.38、0.79。结论针对糖尿病肾病的早期诊断,血清Cys-C、HbA1c和AcR具有较高的诊断效能,诊断价值较高,能够为糖尿病肾病的诊疗提供帮助。

血清C肽、尿微量白蛋白与糖化血红蛋白应用于糖尿病肾病诊断中的效果分析

目的探究血清C肽(C-PR)、尿微量白蛋白(mAlb)与糖化血红蛋白(HbA1c)应用于糖尿病肾病(diabetic nephropathy,DN)的诊断效果。方法回顾性分析2021年4月—2022年4月麻城市人民医院检验科收治的95例糖尿病(diabetes mellitus,DM)患者的临床资料,依据是否合并肾病划分为DM组(50例)、DN组(45例),基于相同时期选取到本院接受健康体检的志愿者60名作为对照组,均接受C-PR、mAlb、HbA1c检测,分析联合检测效果。结果DN组C-PR水平最低,对照组最高,DN组mAlb、HbA1c水平最高,对照组最低,差异有统计学意义(P<0.05)。联合检测诊断灵敏度97.78%、特异度93.33%,均显著高于C-PR、mAlb或HbA1c单一检测结果,差异有统计学意义(P<0.05)。结论在DN患者中实施C-PR、mAlb、HbA1c联合检测具有较高的诊断价值,便于患者尽早得到有效治疗。

Use of glycated albumin for the identification of diabetes in subjects from northeast China

BACKGROUND Metabolic memory is important for the diagnosis and treatment of diabetes in the early stage,and in maintaining blood glucose concentrations within the normal range.The clinical diagnosis of diabetes mellitus is currently made using fasting plasma glucose,2 h-plasma glucose(2h-PG)during a 75 g oral glucose tolerance test,and hemoglobin A1c(HbA1c)level.However,the fasting plasma glucose test requires fasting,which is a barrier to screening,and reproducibility of the 2h-PG level is poor.HbA1c is affected by a shortened red blood cell lifespan.In patients with anemia and hemoglobinopathies,the measured HbA1c levels may be inaccurate.Compared with HbA1c,glycated albumin(GA)is characterized by more rapid and greater changes,and can be used to diagnose new-onset diabetes especially if urgent early treatment is required,for example in gestational diabetes.In this study,we provided cutoff values for GA and evaluated its utility as a screening and diagnostic tool for diabetes in a large high-risk group study.AIM To evaluate the utility of GA in identifying subjects with diabetes in northeast China,and to assess the diagnostic accuracy of the proposed GA cutoff in the diagnosis of diabetes mellitus.METHODS This cross-sectional study included 1935 subjects,with suspected diabetes or in high-risk groups,from 2014 to 2015 in the Second Affiliated Hospital of Harbin Medical University(Harbin,China).The use of GA to identify diabetes was investigated using the area under the receiver operating characteristic curve(AUC).The GA cutoffs were derived from different 2h-PG values with hemoglobin A1c cutoffs used as a calibration curve.RESULTS The GA cutoff for the diagnosis of diabetes mellitus was 15.15%from the receiver operating characteristic(ROC)curve.ROC analysis demonstrated that GA was an efficient marker for detecting diabetes,with an AUC of 90.3%.CONCLUSION Our study supports the use of GA as a biomarker for the diagnosis of diabetes.

糖尿病性视网膜病变患者空腹血糖、糖化血红蛋白及血清C肽水平与眼底病变严重程度的相关性分析

目的分析糖尿病性视网膜病变(diabetic retinopathy,DR)患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)及血清C肽(C-PR)水平与眼底病变的相关性。方法选取2019年11月—2021年12月昆明医科大学附属昭通医院收治的90例DM患者作为研究对象,依据《糖尿病视网膜病变临床指南》将90例DM患者分为无DR组(n=45)和DR组(n=45)。同时选取同期在本院开展健康体检的45名健康人群设为对照组。比较3组FPG、HbA1c、血清C-PR水平。依据糖尿病视网膜病变分期将有DR组分为Ⅰ期(n=15)、Ⅱ期(n=9)、Ⅲ期(n=10)、Ⅳ期(n=11),并比较不同程度DR患者FPG、HbA1c、血清C-PR水平,采用Pearson相关分析FPG、HbA1c、血清C-PR水平和眼底病变的相关性,通过多因素Logistic回归分析方法分析影响增殖期DR发生的因素,采用ROC曲线评估模型诊断效能。结果与对照组和无DR组相比较,DR组FPG、HbA1c水平较高,血清C-PR水平较低,差异有统计学意义(P<0.05)。Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期DR患者的FPG、HbA1c、血清C-PR水平比较,差异有统计学意义(P<0.05)。Pearson相关分析显示,DR患者FPG、HbA1c水平与眼底病变严重程度程度呈正相关(r=0.629、0.583,P<0.05),血清C-PR水平与DR患者眼底病变严重程度程度呈负相关(r=-0.431,P<0.05)。多因素Logistic回归分析,FPG、HbA1c、血清C-PR水平是增殖期DR发生的独立影响因素。ROC曲线结果表明,上述3种指标联合检测增殖期DR的AUC为0.969,灵敏度、特异度分别为90.90%、81.81%。结论DR患者FPG、HbA1c、血清C-PR水平和眼底病变程度有紧密关联,眼底病变程度越严重,其FPG、HbA1c水平越高,血清C-PR水平越低,且FPG、HbA1c、血清C-PR 3种指标联合检测在评估增殖期DR的发生方面具有一定临床应用价值。

血清C肽与糖化血红蛋白诊断老年糖尿病肾病的临床价值

目的探讨血清C肽与糖化血红蛋白(HbA1c)在诊断老年糖尿病肾病(diabetic nephropathy,DN)中的临床应用价值。方法回顾性选取2020年11月—2021年12月福建省老年医院收治的60例老年糖尿病(diabe-tes mellitus,DM)患者(设为观察组)和在本院进行健康体检的60名健康老年人(设为对照组)。按照《糖尿病肾病防治专家共识(2014年版)》中糖尿病肾病(DN)的诊断标准,将观察组分为单纯DM组(n=33)和DN组(n=27)。对患者HbA1c、血清C肽水平进行检测。分别对照组和观察组、单纯DM组和DN组的HbA1c、血清C肽水平予以比较,建立风险评估模型,经受试者工作特征曲线(ROC)分析HbA1c联合血清C肽评估老年DN的诊断效能。结果与对照组相比较,观察组HbA1c水平较高,血清C肽水平较低,差异有统计学意义(P<0.05)。DN组HbA1c、血清C肽水平水平明显高于单纯DM组,差异有统计学意义(P<0.05)。由ROC曲线分析,采用HbA1c、血清C肽联合检测DN的AUC值最高,为0.978,且灵敏度、特异度分别为96.66%、86.66%。结论老年DN患者的HbA1c水平健康较人群明显升高,血清C肽水平明显降低;与单纯DM患者相比较,DN患者的HbA1c、血清C肽水平较高。HbA1c、血清C肽指标联合检测在诊断老年DN患者方面具有较高的临床应用价值。

CysC及HbA1c指标检测在糖尿病肾病患者临床诊断中的检验阳性率及预测价值

目的研究胱抑素C(cystatin C,CysC)及糖化血红蛋白(glycosylated hemoglobin,HbA1c)指标检测在糖尿病肾病患者临床诊断中的检验阳性率及预测价值。方法将2020年8月—2022年8月福建省宁德市柘荣县总医院东院区接收的76例疑似糖尿病肾病患者纳入研究,分别进行血尿素氮(BUN)、空腹血糖(FPG)、尿微量白蛋白(U-mALB)常规指标检测与在此基础上增加CysC、HbA1c检测,将综合检查视为诊断金标准,比较常规指标检测与增加CysC、HbA1c检测的阳性率、诊断准确率、敏感度、特异度;评估预后治疗的预测价值。结果常规指标检测联合CysC、HbA1c指标检测的诊断准确率、敏感度分别为85.53%、88.89%,均高于常规指标检测,差异有统计学意义(χ^(2)=5.604、4.444,P<0.05);常规指标检测联合CysC、HbA1c指标的曲线下面积AUC(0.843,95%CI:0.712~0.879)高于常规指标检测(P<0.05)。结论CysC及HbA1c指标检测在糖尿病肾病患者临床诊断中有利于提高准确率、敏感度,同时具有较高的预测价值。

血清C肽与糖化血红蛋白检验诊断糖尿病的研究

目的 探讨对糖尿病患者分别完成血清C肽、糖化血红蛋白以及血清C肽+糖化血红蛋白检验的临床价值。方法 选取2020年2月-2022年7月山东省曹县县立医院收治的42例糖尿病患者为研究组,选取同阶段42例健康体检者为参照组。所有研究对象均展开血清C肽、糖化血红蛋白以及血清C肽+糖化血红蛋白检验,对两组研究对象的血清C肽、糖化血红蛋白水平展开对比,并且3种检查方法诊断糖尿病的诊断效能展开对比。结果 研究组糖化血红蛋白水平高于参照组,血清C肽水平低于参照组,差异有统计学意义(P<0.05)。血清C肽检查显示,阳性患者30例,阴性患者54例;糖化血红蛋白检查显示,阳性患者25例,阴性患者59例;血清C肽+糖化血红蛋白检查显示,阳性患者41例,阴性患者43例;血清C肽+糖化血红蛋白检查敏感度、准确度均高于血清C肽、糖化血红蛋白检测,差异有统计学意义(P<0.05)。结论 临床对糖尿病患者在实施诊断期间,血清C肽+糖化血红蛋白检验方式的联合应用,可将显著提高诊断效能,而且发现同健康者比较,糖尿病患者的血清C肽、糖化血红蛋白水平呈现出明显差异,从而在糖尿病确诊中表现出一定价值。

血清C肽和糖化血红蛋白结合检验方法在糖尿病诊断中的实施价值分析

目的 探讨血清C肽和糖化血红蛋白结合检验方法在糖尿病诊断中的实施价值。方法 选取2022年1—12月即墨区第二人民医院收治的疑似糖尿病患者200例作为研究对象。对患者的糖化血红蛋白水平、C肽水平等进行记录,分析联合检测的诊断效能。结果 联合检测的准确度(98.0%)高于糖化血红蛋白单一检测,差异有统计学意义(χ^(2)=35.470,P<0.05),联合检测的特异度、敏感度均高于糖化血红蛋白单一检测,差异有统计学意义(P<0.05)。结论 在糖尿病诊断过程中,采取血清C肽和糖化血红蛋白结合检验方法,有助于提高糖尿病的诊断准确性,值得在临床推广、应用。