体重指数筛查中老年人糖尿病前期和糖尿病的适宜切点研究

发布时间：2019-04-03 12:11

【摘要】：目的确定一个适用于筛查中老年人糖尿病前期(Pre-DM)和糖尿病(DM)的体重指数(BMI)切点。方法从长沙市某体检中心2014年体检人群中纳入研究对象2 621例,分别根据ADA(2010)和WHO(1999)标准诊断DM/Pre-DM。计算BMI诊断DM/Pre-DM的受试者工作特征曲线下面积(AUROC)及不同BMI切点(21~28)kg/m~2筛查DM或DM和Pre-DM的敏感性、特异性和约登指数。结果研究对象平均年龄(53.7±11.1)岁,平均BMI(24.2±2.9)kg/m~2,DM患病率6.9%,Pre-DM患病率8.1%(WHO)、24.3%(ADA)。BMI诊断Pre-DM/DM的准确性较低(AUROC0.7),不同BMI切点下约登指数均较小(3.6%~29.2%),但敏感性波动较大(12.8%~95.0%);总人群BMI切点24 kg/m~2对应最大约登指数,但在该切点下女性超过一半Pre-DM/DM患者漏诊(54.6%);男女性BMI切点分别为23 kg/m~2和22 kg/m~2时,敏感性接近80%,与切点24kg/m~2比较,特异性减小,约登指数差异无统计学意义。结论 BMI单独用于诊断中老年人Pre-DM/DM的准确性较低,适宜的筛查切点应降低,男女性分别为23 kg/m~2和22 kg/m~2。
[Abstract]:Objective to determine a (BMI) cut point of body mass index (BMI) suitable for screening pre-diabetes mellitus (Pre-DM) and diabetic (DM) in middle-aged and elderly people. Methods A total of 2 621 subjects were enrolled from a physical examination center in Changsha City in 2014. DM/Pre-DM. was diagnosed according to ADA (2010) and WHO (1999) criteria, respectively. The sensitivity, specificity and Jordan index of the area under the operating characteristic curve (AUROC) and the kg/m~2 screening of DM or DM and Pre-DM at different BMI tangent points (21? 28) in BMI diagnosis of DM/Pre-DM were calculated. Results the average age of the subjects was (53.7 卤11.1) years, the average prevalence of BMI was (24.2 卤2.9) kg/m~2,DM was 6.9%, and the prevalence rate of prep DM was 8.1% (WHO),. 24.3% (ADA). The accuracy of diagnosis of Pre-DM/DM was low (AUROC0.7), but the sensitivity fluctuated greatly (12.8% / 95.0%) at different BMI cut points (3.6% / 29.2%). The BMI cut-point 24-kg/m~2 correspondence index of the total population was the most approximate, but more than half of the female patients with Pre-DM/DM missed the diagnosis (54.6%) under this cut-off point. When the cut point of BMI was 23 kg/m~2 and 22 kg/m~2, the sensitivity was close to 80% in male and female. Compared with 24kg/m~2, the specificity was decreased, but the difference of Joden index was not statistically significant. Conclusion the diagnostic accuracy of BMI alone for middle-aged and elderly patients with Pre-DM/DM is low, and the appropriate screening cut point should be reduced, 23 kg/m~2 and 22 kg/m~2. for males and females, respectively.
【作者单位】：中南大学湘雅公共卫生学院;长沙市中心医院口腔科;
【分类号】：R587.1

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