西宁地区HbA1c在高危人群诊断T2DM的价值

发布时间：2018-03-22 16:06

  本文选题：2型糖尿病　切入点：糖化血红蛋白　出处：《青海大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的探讨西宁地区高危人群应用空腹血糖(FPG)、餐后两小时血糖(2h PG)、糖化血红蛋白(Hb A1c)诊断2型糖尿病(T2DM)的优劣性以及其灵敏度的比较;糖化血红蛋白(Hb A1c)诊断T2DM的切点值。方法收集西宁地区就诊人群中的糖尿病高危人群,通过入选标准和排除标准,297例(男192例,女105例)入选为研究对象,男性平均年龄50.6±11.67岁;女性平均年龄56.93±9.85岁,研究对象均进行葡萄糖耐量(OGTT)试验,同时测定糖化血红蛋白(HbA1c)。结果①根据WHO关于T2DM标准,297例中T2DM,192例,糖代谢异常(IGR),42例,正常糖耐量(NGT)63例;②受试者工作曲线(ROC曲线)结果:2hPG曲线下面积:0.996(95%CI 0.988~1.000),FPG曲线下面积:0.980(95%CI 0.966~0.995),HbA1c曲线下面积:0.952(95%CI 0.927~0.977);③ROC曲线分析,西宁地区HbA1c诊断T2DM的最佳切点为6.25%,此时的敏感度90.1%,特异度87.3%,阳性预测值95.6%,阴性预测值74.3%;FPG≥7.0mmol/L诊断T2DM时,灵敏度65.1%,特异度100%,阳性预测值100%,阴性预测值48.5%,2hPG≥11.1mmol/L诊断T2DM时,灵敏度96.9%,特异度100%,阳性预测值100%,阴性预测值91.3%。结论①应用FPG诊断T2DM优于HbA1c,但其漏诊率较高;②西宁地区HbA1c断T2DM的切点值为6.25%;③应用HbA1c≥6.25%诊断糖尿病比应用FPG≥7.0mmol/L的灵敏度高,与2hPG≥11.1mmol/L诊断T2DM的灵敏度相似。
[Abstract]:Objective to explore the advantages and disadvantages and sensitivity of fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h) and HbA1c (HbA1c) in the diagnosis of type 2 diabetes mellitus (T2DM) in high risk population in Xining area. Methods A total of 297 patients (192 males and 105 females) with high risk of diabetes mellitus in Xining area were enrolled in the study. The mean age of males was 50.6 卤11.67 years old. The mean age of female was 56.93 卤9.85 years old. All the subjects were tested with OGTT, and HbA1cU was determined simultaneously. Results 1 according to WHO standard, there were 192 cases of T2DMN and 42 cases of abnormal glucose metabolism. Results: the area under the 2 hPG curves was 1: 0.996 (95% CI 0.988 1.000). Under the FPG curve, the area under the FPG curve was: 0. 980, 95 CI 0. 966 and 0. 995. The area under the 1. 952 95 CI 0. 927 and 0. 977 C curves were analyzed. The best cut point for HbA1c diagnosis of T2DM in Xining area is 6.25. The sensitivity is 90.1, the specificity is 87.3, the positive predictive value is 95.6, and the negative predictive value is 74.30.The sensitivity is 65.1, the specificity is 100, the positive predictive value is 100, and the negative predictive value is 48.52hPG 鈮，

本文编号：1649381