张震 1李军 2李思源 1吴媛媛 1周婷 3叶婷2
作者信息
- 1. 832000新疆石河子市,新疆石河子大学医学院
- 2. 新疆石河子大学医学院第一附属医院内分泌代谢科
- 3. 新疆石河子大学医学院第一附属医院中心实验室
- 折叠
摘要
Abstract
Objective To evaluate the value of glycosylated hemoglobin ( HbA1c ) in the screening and diagnosis of diabetes mellitus ( DM ).Methods A total of 251 patients requiring detection of DM in our department between June 2011 and June 2012 underwent oral glucose tolerance test ( OGTT), and determination of fasting plasma glucose ( FPG ), 2 hours plasma glucose ( 2 hPG ), and HbA1c.SPSS 17.0 was used to conduct univariate analysis and SNK - q test.MedCalc 9.0 was used to plot receiver operating characteristic ( ROC ) curve to obtain the best critical point of HbA1c and FPG in diagnosing DM, and the area under the curve ( AUC ).Results OGTT results showed 168 cases ( 66.9% ) of DM, 70 cases ( 27.9% ) of impaired glucose regulation ( IGR ), and 13 cases ( 5.2% ) of normal glucose tolerance ( NGT ).Significant difference was observed a-mong the three groups in levels of FPG, 2 hPG, and HbA1c ( P<0.01 ).To be specific, level of 2 hPG of the IGR group was significantly higher than that of the NGT group, levels of FPG, 2 hPG, and HbA1c of the DM group were significantly higher than those of the NGT and IGR group ( P < 0.05 ).The optimal cut - point of HbA1c in ROC curve was 7.0% , with sensitivity of 91.07% [95% CI ( 0.857, 0.949 )], specificity of 92.77% [ 95% CI ( 0.849, 0.973 )], AUC of 0.971 [ 95% CI ( 0.942 , 0.988 ) ], Youden index of 0.84, positive predictive value ( + PV ) of 96.2% , negative predicative value ( - PV ) of 83.7% , positive likelihood ratio ( + LR ) of 12.60, and negative likelihood ratio ( - LR ) of 0.10.The optimal cut - point of FPG in ROC curve was 6.9 mmol/L, with sensitivity of 80.95% , specificity of 100.00% , AUC of 0.944 [ 95% CI ( 0.908 , 0.969 )], Youden index of 0.81, + PV of 100.0% , and - PV of 72.2% .Conclusion HbA1c can be used as a screening and diagnostic criterion for DM and the optimal cut - point is 7.0% .HbA1c has higher sensitivity but lower sensitivity than FPG.关键词
糖化血红蛋白/糖尿病/空腹血糖/口服葡萄糖耐量试验/受试者工作特征曲线Key words
Glycated hemoglobin/ Diabetes mellitus/ Fasting plasma glucose/ Oral glucose tolerance test/ Receiver operating characteristic curve分类
医药卫生
