中国现代医学杂志2017，Vol.27Issue(7)：80-84,5.DOI:10.3969/j.issn.1005-8982.2017.07.018
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
Optimal cut-off points of BMI for screening of pre-diabetes and diabetes in middle-aged and elderly people
肖婉 1许林勇 1齐潇 1倪斌 2谢赐福1
作者信息
- 1. 中南大学湘雅公共卫生学院,湖南 长沙 410078
- 2. 长沙市中心医院 口腔科,湖南 长沙 410004
- 折叠
摘要
Abstract
Objective To identify the BMI cut-off points most practical for screening pre-diabetes (Pre-DM) and diabetes (DM) in middle-aged and older adults. Methods Totally 2,621 subjects who attended regular health examination in a physical examination center of Changsha in 2014 were included, And the participants were diagnosed with Pre-DM or DM using ADA criteria (2010) and WHO criteria (1999), respectively. The area under ROC curve (AUC) for BMI diagnosis of Pre-DM or DM was calculated; as well as the sensitivity, specificity and Youden index under different BMI cut-off points (ranging from 21 to 28 kg/m2). Results The mean age was (53.7 ± 11.1) years, and the mean BMI was (24.2 ± 2.9) kg/m2. The prevalence of DM were 6.9% and that of Pre-DM was 8.1%(WHO) or 24.3%(ADA), respectively. The accuracy of BMI diagnosis of Pre-DM or DM was low (AUC<0.7), the sensitivity varied widely (12.8%-95.0%), although Youden index varied minimally across BMI cut-point (3.6%-29.2%). The BMI cut-point with the highest Youden index was 24 kg/m2, but limited screening at this cut-point would miss almost half of Pre-DM/DM diagnosis in women (54.6%). At BMI≥23 kg/m2 for men and BMI≥22 kg/m2 for women, the sensitivity of screening Pre-DM or DM would approximately equal to 80%;compared with the cut-off point of 24 kg/m2, the specificity decreased, there was no significant difference in the Youden index. Conclusions BMI alone is not an effective indicator for diagnosis of Pre-DM or DM in middle-aged and older adults, and the optimal BMI cut-off points for screening Pre-DM/DM should be lowered to 23 kg/m2 for men and 22 kg/m2 for women.关键词
糖尿病/糖尿病前期/体重指数/筛查Key words
diabetes/pre-diabetes/body mass index/screening分类
医药卫生引用本文复制引用
肖婉,许林勇,齐潇,倪斌,谢赐福..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[J].中国现代医学杂志,2017,27(7):80-84,5.
