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年龄对糖化血红蛋白和糖化血清白蛋白筛查糖尿病的影响

来自:中国糖尿病杂志  编辑:李萌 罗樱樱 杨晓燕 刘蔚 张秀英 任倩|点击数:|2015-04-30

  糖尿病临床流行病学

  【摘要】目的 研究年龄对HbA1c和糖化血清白蛋白(GA)筛查糖尿病的准确性的影响。 方法 选取北京2个社区年龄≥20岁的志愿者876名,以及全国37家医院的就诊者9592例。行75 g OGTT并测定HbA1c。按年龄三分位数分组,绘制2个人群中HbA1c,以及社区人群中GA筛查糖尿病的受试者工作特征(ROC)曲线,比较各年龄组曲线下面积(AUC),计算HbA1c和GA在最佳切点上筛查糖尿病的敏感性和特异性。结果 在社区人群中,HbA1c筛查糖尿病的AUC年龄在21~50、51~57及58~79岁组分别为0.977、0.934及0.865 (P <0.005);GA筛查糖尿病的AUC年龄在上述年龄组分别为0.903、0.854及0.845(P=0.591)。在医院人群中,HbA1c筛查糖尿病的AUC年龄在18~47、48~59及60~75岁组分别为0.936、0.889及0.849(P<0.05)。 结论 HbA1c筛查糖尿病的准确性随年龄增加而降低,年龄对GA筛查糖尿病准确性的影响尚需进一步研究。

  【关键词】糖尿病;糖化血红蛋白;糖化血清白蛋白;筛查;年龄

  【Abstract】Objective To evaluate the effect of age on the performance of hemoglobin(HbA1c) and glycated albumin(GA)for detecting undiagnosed diabetes in Chinese populations. Methods Twostudy populations came from communities and hospitals, respectively. A total of 876 volunteers aged ≥20 years without known diabetes living in two communities in Beijing were recruited. Data of 9592 individuals without known diabetes from 37 hospitals in China were collected. 75g glucose tolerance tests (OGTT) were performed, and HbA1c and GA were measured. Individuals were divided into groups based on age tertiles. Receiver operating characteristic curves (ROCs) were plotted and the areas under the curves (AUCs) for HbA1c and GA values were compared among three age groups. Results The ROC AUC of HbA1c for detecting diabetes in the 21~50, 51~57 and 58~79 years age group in the community population was 0.977, 0.934 and 0.865 (P < 0.005), respectively. the ROC AUC of GA for detecting diabetes was 0.903,0.854 and 0.845 (P =0.591), respectively. The ROC AUC of HbA1c for detecting diabetes in the 18~47, 48~59 and 60~75 years age group in the hospital population was 0.936,0.889 and 0.849(P<0.05), respectively. Conclusions The accuracy of HbA1c for detecting undiagnosed diabetes decreases with increasing age. The impact of age on GA for detecting diabetes needs further investigation.

  【Key words】Diabetes mullitus;Hemoglobin (A1c);Glycatedalbumin(GA);Screening;Age

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