[1]刘树馨,时立新,张淼,等.HbA1c对中老年人糖尿病及糖调节受损诊断价值的探讨[J].国际内分泌代谢杂志,2016,36(06):361-365.[doi:10.3760/cma.j.issn.1673-4157.2016.06.01]
 Liu Shuxin,Shi Lixin,Zhang Miao,et al.Debate on the value of HbA1c in the diagnosis of diabetes and impaired glucose regulation in middle aged and elderly people[J].International Journal of Endocrinology and Metabolism,2016,36(06):361-365.[doi:10.3760/cma.j.issn.1673-4157.2016.06.01]
点击复制

HbA1c对中老年人糖尿病及糖调节受损诊断价值的探讨()
分享到:

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
36
期数:
2016年06期
页码:
361-365
栏目:
论著
出版日期:
2016-11-20

文章信息/Info

Title:
Debate on the value of HbA1c in the diagnosis of diabetes and impaired glucose regulation in middle aged and elderly people
作者:
刘树馨时立新张淼张巧彭年春徐淑静张松胡颖
550004 贵阳,贵州医科大学附属医院内分泌代谢病科(第一作者现在贵州医科大学附属医院综合病房)
Author(s):
Liu Shuxin Shi LixinZhang Miao Zhang Qiao Peng Nianchun Xu ShujingZhang Song Hu Ying.
Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
关键词:
HbA1c 糖尿病 糖调节受损
Keywords:
HbA1c Diabetes mellitus Impaired glucose regulation
DOI:
10.3760/cma.j.issn.1673-4157.2016.06.01
摘要:
目的 探讨HbA1c诊断中老年人糖尿病、糖调节受损的最佳切点。方法 采用整群随机抽样方法选取贵阳市云岩区40岁及以上,且居住5年以上的中老年人共8 803名。所有研究对象进行口服葡萄糖耐量试验(OGTT)及检测HbA1c等指标。对HbA1c诊断糖尿病、糖调节受损的切点进行分析; 按年龄分层分析HbA1c诊断糖尿病在不同年龄段的切点。结果 HbA1c诊断新发现糖尿病的切点为6.4%的特异性较高(86.8%),相应的敏感性为68.0%。HbA1c诊断糖调节受损的受试者工作曲线下面积偏低(0.558)。40~49 岁年龄组HbA1c诊断糖尿病的切点值最低,为6.1%; 而70~岁年龄组HbA1c诊断糖尿病切点值最高,为6.6%。结论 中老年人群中HbA1c 6.4%为诊断糖尿病的最佳切点,HbA1c不适合作为诊断糖调节受损的指标。
Abstract:
Objective To investigate the best cut-off points of HbA1c for the diagnosis of diabetes and impaired glucose regulation(IGR)in middle aged and elderly people. Methods A total of 8 803 subjects, aged over 40 years old and lived in the community for more than 5 years, were selected from Yunyan District of Guiyang city using a cluster random sampling method. All subjects received oral glucose tolerance test(OGTT)and HbA1c checking. The cut-off points of HbA1c for diagnosis of diabetes and IGR were analyzed and compared between populations with different age. Results The cut-off point of HbA1c was 6.4% for diagnosis of new diabetes with the specificity of 86.8% and the sensitivity of 68.0%. The maximum area of the receiver operating curve of HbA1c was low in the diagnosis of IGR(0.558).Among populations with different age, the lowest cut-off point of HbA1c(6.1%)was found in subjects aged 40-49 years old whereas the highest cut-off point of HbA1c(6.6%)was found in subjects aged over 70 years. Conclusions The best cut-off point of HbA1c for the diagnosis of diabetes is 6.4% for middle-aged and elderly people. HbA1c may not be a good marker for the diagnosis of IGR.

参考文献/References:

[1] Rose E, Ketchell D, Markova T. Clinical inquiries. Does daily monitoring of blood glucose predict hemoglobin A1c levels?[J]. J Fam Pract,2003,52(6):485-490.
[2] WHO Guidelines Approved by the Guidelines Review Committee.Use of glycated haemoglobin(HbA1c)in the diagnosis of diabetes mellitus: abbreviated report of a WHO consultation.Geneva: World Health Organization,2011. Available from: URI: http://www.who.int/diabetes/publications/diagnosis-diabetes2011/en/
[3] Nakagami T, Tominaga M, Nishimura R, et al. Is the measurement of glycated hemoglobin A1c alone an efficient screening test for undiagnosed diabetes? Japan National Diabetes Survey[J]. Diabetes Res Clin Pract,2007,76(2):251-256.
[4] Bennett CM, Guo M, Dharmage SC. HbA(1c)as a screening tool for detection of type 2 diabetes: a systematic review[J].Diabet Med,2007,24(4):333-343.DOI:10.1111/j.1464-5491.2007.02106.x.
[5] 田慧,李春霖,方福生,等. 糖化血红蛋白诊断糖尿病切点的横断面研究[J]. 中华内分泌代谢杂志,2011,27(5):375-380. DOI: 10.3760/cma.j.issn.1000-6699.2011.05.004.
[6] American Diabetes Association. Diagnosis and classification of diabetes mellitus[J]. Diabetes Care, 2010, 33(Suppl 1):S62-S69. DOI:10.2337/dc10-S062.
[7] Rohlfing CL, Little RR, Wiedmeyer HM, et al. Use of GHb(HbA1c)in screening for undiagnosed diabetes in the U.S. population[J]. Diabetes Care,2000, 23(2):187-191.
[8] Buell C, Kermah D, Davidson MB. Utility of A1C for diabetes screening in the 1999 2004 NHANES population[J].Diabetes Care,2007,30(9):2233-2235. DOI:10.2337/dc07-0585.
[9] Kumar PR, Bhansali A, Ravikiran M,et al. Utility of glycated hemoglobin in diagnosing type 2 diabetes mellitus: a community-based study[J].J Clin Endocrinol Metab, 2010,95(6):2832-2835. DOI: 10.1210/jc.2009-2433.
[10] Anand SS, Razak F, Vuksan V,et al. Diagnostic strategies to detect glucose intolerance in a multiethnic population[J].Diabetes Care, 2003,26(2):290-296.
[11] 王连升,庄兴,张琦,等.糖化血红蛋白对糖尿病的诊断价值[J].临床检验杂志,2011,29(3):193-194.
[12] 储小宏,丛安丽,吴邦庆,等.HbA1c与OGTT在糖尿病诊断中的应用比较[J].安徽医科大学学报,2011,57(9):982-983.
[13] Bao Y,Ma X,Li H,et al.Glyeated haemobin A1c for diagnosing diabetes in Chinese population:cross sectional epidemiological survey[J].BMJ,2010,340:c2249.DOI:10.1136/bmj.C2249.
[14] International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes[J].Diabetes Care,2009,32(7):1327-1334. DOI: 10.2337/dc09-9033.
[15] Deepa R, Shanthi Rani S, Premalatha G,et al. Comparison of ADA 1997 and WHO 1985 criteria for diabetes in south Indians-the Chennai Urban Population Study. American Diabetes Association[J]. Diabet Med,2000,17(12):872-874.
[16] Petersen PH, J rgensen LG, Brandslund I,et al. Consequences of bias and imprecision in measurements of glucose and HbA1c for the diagnosis and prognosis of diabetes mellitus[J].Scand J Clin Lab Invest Suppl,2005,240:51-60. DOI:10.1080/00365510500236135.
[17] 周翔海,纪立农.空腹血糖和糖化血红蛋白用于筛查糖尿病的研究[J]. 中华糖尿病杂志,2005,13(3):203-205. DOI:10.3321/j.issn:1006-6187.2005.03.018.
[18] Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China[J]. N Engl J Med, 2010, 362(12): 1090-1101.DOI:10.1056/NEJMoa0908292.

相似文献/References:

[1]李春睿,王静,陈峰,等.GLP-1受体激动剂对糖尿病患者肾功能的影响[J].国际内分泌代谢杂志,2014,(06):401.[doi:10.3760/cma.j.issn.1673-4157.2014.06.011]
 Li Chunrui*,Wang Jing,Chen Feng,et al.Effects of GLP-1 receptor agonists on renal function of diabetics[J].International Journal of Endocrinology and Metabolism,2014,(06):401.[doi:10.3760/cma.j.issn.1673-4157.2014.06.011]
[2]黄珊珊,鲁一兵.长链非编码RNA与糖尿病[J].国际内分泌代谢杂志,2015,(04):271.[doi:10.3760/cma.j.issn.1673-4157.2015.04.016]
 Huang Shanshan*,Lu Yibing..Long non-coding RNA and diabetes mellitus[J].International Journal of Endocrinology and Metabolism,2015,(06):271.[doi:10.3760/cma.j.issn.1673-4157.2015.04.016]
[3]高瑞霄,姚朱华,冯凭,等.尿8-羟基脱氧鸟苷在2型糖尿病及糖尿病合并冠心病患者中的临床意义[J].国际内分泌代谢杂志,2014,(05):295.[doi:10.3760/cma.j.issn.1673-4157.2014.05.002]
 Gao Ruixiao*,Yao Zhuhua,Feng Ping,et al.The clinical significance of urinary 8-hydroxy deoxyguanosine in patients with type 2 diabetes mellitus and diabetic patients with coronary heart disease[J].International Journal of Endocrinology and Metabolism,2014,(06):295.[doi:10.3760/cma.j.issn.1673-4157.2014.05.002]
[4]郑佳,肖新华.葡萄糖稳态的中枢调控作用机制 ——2014年美国糖尿病协会“杰出科学成就奖” 演讲报告解读[J].国际内分泌代谢杂志,2014,(05):305.[doi:10.3760/cma.j.issn.1673-4157.2014.05.004]
 Zheng Jia,Xiao Xinhua.The mechanisms of central nervous system in the control of glucose homeostasis--A summary of 2014 ADA "Outstanding Scientific Achievement Award" Lecture[J].International Journal of Endocrinology and Metabolism,2014,(06):305.[doi:10.3760/cma.j.issn.1673-4157.2014.05.004]
[5]唐勤,邵莉.蛋白乙酰化与胰岛素分泌[J].国际内分泌代谢杂志,2014,(05):313.[doi:10.3760/cma.j.issn.1673-4157.2014.05.007]
 Tang Qin,Shao Li..Protein acetylation and insulin secretion[J].International Journal of Endocrinology and Metabolism,2014,(06):313.[doi:10.3760/cma.j.issn.1673-4157.2014.05.007]
[6]卢婷婷,任思佳,沈捷.人群迁徙对糖尿病患病率的影响及其相关因素[J].国际内分泌代谢杂志,2014,(05):327.[doi:10.3760/cma.j.issn.1673-4157.2014.05.011]
 Lu Tingting,Ren Sijia,Shen Jie..Impact of migration on prevalence of diabetes and risk factors[J].International Journal of Endocrinology and Metabolism,2014,(06):327.[doi:10.3760/cma.j.issn.1673-4157.2014.05.011]
[7]包薇萍,陈国芳,刘超.DPP-4抑制剂的肾保护作用[J].国际内分泌代谢杂志,2014,(05):337.[doi:10.3760/cma.j.issn.1673-4157.2014.05.014]
 Bao Weiping,Chen Guofang,Liu Chao..Renal protective effects of dipeptidyl peptidase-4 inhibitors[J].International Journal of Endocrinology and Metabolism,2014,(06):337.[doi:10.3760/cma.j.issn.1673-4157.2014.05.014]
[8]孟庆冬,陶红.巨噬细胞凋亡与糖尿病动脉粥样硬化[J].国际内分泌代谢杂志,2014,(05):340.[doi:10.3760/cma.j.issn.1673-4157.2014.05.015]
 Meng Qingdong,Tao Hong..Macrophage apoptosis and diabetic atherosclerosis[J].International Journal of Endocrinology and Metabolism,2014,(06):340.[doi:10.3760/cma.j.issn.1673-4157.2014.05.015]
[9]赵荷珺 洪天配.胰高血糖素样肽-1类药物与胰腺安全性[J].国际内分泌代谢杂志,2015,(05):319.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.008]
 Zhao Hejun*,Hong Tianpei..Glucagon-like peptide-1-based therapies and pancreatic safety[J].International Journal of Endocrinology and Metabolism,2015,(06):319.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.008]
[10]吕丹 李晓思 陈树春 王泽普.Betatrophin:糖尿病再生治疗的新希望[J].国际内分泌代谢杂志,2015,(05):351.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.016]
 Lyu Dan*,Li Xiaosi,Chen Shuchun,et al.Betatrophin:new hope for regeneration therapy of diabetes[J].International Journal of Endocrinology and Metabolism,2015,(06):351.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.016]
[11]孙曾梅 王溯源 何华 孙舒瑶 叶燕 姚璿羽 龙文春 张惠勤 张成慧 李明霞 唐冬梅 邬云红.HbA1c对高原不同血红蛋白人群 糖代谢异常诊断价值的研究[J].国际内分泌代谢杂志,2019,39(02):73.[doi:10.3760/cma.j.issn.1673-4157.2019.02.001]
 Sun Zengmei,Wang Suyuan,He Hua,et al.The value of HbA1c for diagnosis of abnormal glucose metabolism in highland dwellers with different hemoglobin levels[J].International Journal of Endocrinology and Metabolism,2019,39(06):73.[doi:10.3760/cma.j.issn.1673-4157.2019.02.001]

备注/Memo

备注/Memo:
基金项目:贵州省科技厅社会攻关计划(SY[2010]3150)
更新日期/Last Update: 2016-12-20