·糖尿病临床流行病学·

　　2型糖尿病及糖耐量减低筛查方法的效果比较

　　艾雅琴 杨锐 陈宏 彭湘杭 李沛霖 叶文慧 王先宝 刘玲萍 蔡德鸿

　　【摘要】 目的 比较FBG、糖尿病危险积分(DRS)表、HbA1c筛查T2DM及IGT的效果。 方法 研究对象458名，采集FBG、填写DRS表，一周后行OGTT并测定HbA1c及血脂四项。 结果 当筛查T2DM时，FBG切点为5.6mmol/L，DRS切点为9分，HbA1c切点为5.8%。HbA1c筛查效果较好，灵敏度为74.36%，特异度为81.55%。当筛查T2DM及IGT时，FBG切点为5.8mmol/L，DRS切点为9分，HbA1c切点为5.9%。DRS筛查效果较好，灵敏度为70.31%，特异度为79.37%。 结论 与FBG、DRS相比HbA1c筛查T2DM的效果较好，HbA1c及FBG不适用于筛查T2DM及IGT，而DRS筛查T2DM及IGT的效果较好。

　　【关键词】糖尿病，2型;糖耐量减低;筛查

　　Effects of different ways in screening type 2 diabetes and impaired glucose tolerance AI Ya-qin, YANG Rui, CHEN Hong, et al. Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China

　　Corresponding author: CAI De-hong, E-mail: jimzhua@163.com

　　【Abstract】 Objective To compare the effects of fasting blood glucose (FBG), diabetes risk score (DRS), and glycosylated hemoglobin (HbA1c) in screening type 2 diabetes and impaired glucose tolerance (IGT). Methods The data of 458 subjects were studied. The quantitative value of FBG was collected, the DRS form was filled, the oral glucose tolerance test (OGTT) was performed one week later, and the HbA1c and blood lipid were examined. Results Using the ROC curve in screening, the optimal cut-points of FBG, DRS, HbA1c related to T2DM diagnosed by OGTT were 5.6mmol/L, 9 scores, and 5.8% respectively. The area under the curve of HbA1c was the largest which showed the screening accuracy of HbA1c was better, and its sensitivity and specificity were 74.36% and 81.55% respectively; while the optimal cut-points of FBG, DRS, HbA1c related to T2DM and IGT diagnosed by OGTT were 5.8mmol/L, 9 scores, and 5.9% respectively. The area under the curve of DRS was the largest which showed the screening accuracy of DRS was better, and its sensitivity and specificity were 70.31% and 79.37% respectively. Conclusions Comparing with FBG and DRS, the accuracy of HbA1c for screening T2DM was better. HbA1c and FBG were not reliable to identify T2DM and IGT, but DRS was better.

　　【Key words】Diabetes mellitus, type 2; Impaired glucose tolerance (IGT); Screening