来自:中国糖尿病杂志 编辑:钟玉霞 李思源 李军 张震曹国磊王思瑶|点击数:|2016-04-05
【摘要】 目的 探讨HbA1c在新疆喀什地区维吾尔族T2DM诊断和筛查中的价值。 方法 选取待确诊糖尿病者457名,均行75 g OGTT并测定HbA1c,绘制受试者特征工作(ROC)曲线,分析FPG及HbA1c诊断与筛查T2DM的敏感性和特异性。 结果 以OGTT结果为“金标准”,FPG的ROC曲线的最佳切点为6.995 mmol/L,特异性99.5%,灵敏性96.2%,曲线下面积(AUC)0.994(95%CI: 0.910~0.970),阴性似然比(-LR)0.039,阳性似然比(+LR)213.43。HbA1c的ROC曲线的最佳切点6.95%,特异性97.7%(95%CI: 0.850~0.978),灵敏性98.3%(95%CI: 0.858~0.952),AUC 0.997(95%CI:0.945~0.990),-LR 0.017,+LR 43.64。 结论 HbA1c≥6.95%可作为新疆喀什地区维吾尔族T2DM诊断及筛查的一种有效方法,诊断的敏感性较FPG高,特异性较FPG低。
【关键词】 糖尿病,2型;糖化血红蛋白;空腹血糖;受试者工作特征曲线
The value of glycosylated hemoglobin A1c in screening and diagnosing of type 2 diabetes in Uygur population in Kashi, Xinjiang ZHONG Yu-xia, LI Si-yuan, LI Jun, et al. Department of Endocrinology, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832008, China
【Abstract】 Objective To explore the value of glycosylated hemoglobin(HbA1c) in screening and diagnosing T2DM in Uygur population in Kashi, Xinjiang. Methods 457 subjects from the outpatient and inpatient accepted 75 g OGTT test and HbA1c measurement. ROC curve analysis was used to evaluate the best HbA1c and FPG cut-off points for screening and diagnosing T2DM. Results Taking OGTT as the gold standard, the optimal FPG cut-off point was 6.995 mmol/L, with specificity 99.5%, sensitivity 96.2%, area under the curve (AUC) 0.994 (95%CI:0.910~0.970), negative likelihood ratio(-LR) 0.039,and positive likelihood ratio(+LR) 213.43. The optimal HbA1c cut-off point was 6.95%, with specificity 97.7% (95%CI:0.850~0.978), sensitivity 98.3% (95%CI:0.858~0.952), AUC 0.997 (95%CI:0.945~0.990), –LR 0.017, and +LR 43.64. Conclusions HbA1c≥6.95% can be set as the threshold to diagnose and screen T2DM in Uygur population in Kashi, Xinjinag. Compared with FPG, HbA1c has higher sensitivity but lower specificity.
【Key Words】 Diabetes mellitus, type 2; Glycosylated hemoglobin A1c(HbA1c); Fasting plasma glucose (FPG); Receiver operating characteristic curve(ROC)
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