老年糖代谢异常人群糖化血红蛋白的改变及其与血糖的关系  

The relationship between HbA1c and glucose in elderly of different glycometabolism disorders

作　　者：郑华[1] 潘文丽[1] 马芳玲[1] 邹效漫[1] 母义明[1] 

机构地区：[1]解放军总医院内分泌科,北京100853

出　　处：《中华保健医学杂志》2010年第6期431-433,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨糖化血红蛋白(HbA1c)检测对老年人群不同糖代谢异常状态的临床价值。方法选取1365名老年受试者(其中男550名,女815名,年龄53～93岁)进行口服糖耐量试验(OGTT)和HbA1c检测。根据OGTT结果分为正常糖耐量(NGT)、空腹血糖受损(IFG)、糖耐量受损(IGT)、IFG合并IGT(IFG/IGT)和糖尿病(DM)5组,通过单因素方差分析比较各组HbA1c值、计算95%可信区间并绘制受试者ROC曲线,对各组HbA1c与空腹血糖(FPG)和OGTT2h血糖(2hPG)进行线性相关分析。结果 HbA1c(%)DM组(6.60±1.18)明显高于其余4组(均P<0.01),IFG组(5.74±0.44)、IGT组(5.67±0.38)、IFG/IGT组(5.87±0.43)分别明显高于NGT组(5.51±0.32)(P<0.01)。各组HbA1c95%可信区间为DM(≥5.4单侧)%、IFG(5.1～6.5)%、IGT(4.9～6.4)%、IFG/IGT(5.2～6.8)%、NGT(≤6.0单侧)%,HbA1c在DM组的ROC曲线最佳切点为5.9%,灵敏度84%,特异度62%,曲线下面积0.808,在NGT组的ROC曲线最佳切点为5.6%,灵敏度63%,特异度68%,曲线下面积0.709。DM组HbA1c分别与FPG(r=0.866,P<0.01)和2hPG(r=0.657,P<0.01)存在着明显的正相关;IFG组HbA1c只与FPG(r=0.325,P<0.01)存在正相关;IGT组HbA1c(r=0.275,P<0.01)只与2hPG存在正相关;NGT组HbA1c只与FPG(r=0.207,P<0.01)存在正相关性。结论 HbA1c水平能够正确地反映正常糖代谢、糖调节受损和糖尿病3种不同糖代谢状态的血糖水平,是区分3种糖代谢状态的有用指标。Objective To explore the relationship between HbA1c and glucose in elderly of different glycometabolism disorders. Methods Totally 1365 subjects（550men,815women）underwent an oral glucose tolerance test（OGTT）as well as HbA1c determination. According to the results of OGTT,all subjects were divided into five groups as follows： normal glucose tolerance（NGT）,impaired fasting glucose（IFG）,impaired glucose tolerance（IGT）,IFG combined with IGT（IFG/IGT）and diabetes mellitus（DM）. Then levels of HbA1c were compared one another among 5 groups by using one-way ANOVA. In every group,to count 95% confidential interval,a receiver operating characteristic（ROC）curve,linear correlation analysis for between HbA1c and either fasting plasma glucose（FPG）or postchallenge 2 hour plasma glucose（2hPG）were performed. Results Level of HbA1c（%）in DM（6.60±1.18）was statistically higher（P0.01）than that in any one of the other four groups. IFG group（5.74±0.44）,IGT group（5.67±0.38）and IFG/IGT group（5.87±0.43）the HbA1c levels were statistical significantly higher than that of NGT group（5.51±0.32,P0.01）. In DM group, highly significant correlations were found between HbA1c and either FPG（r=0.866,P0.01）or 2hPG（r=0.657,P0.01）. The 95% confidential interval DM（≥5.4）%、IFG（5.1～6.5）%、IGT（4.9～6.4）%、IFG/IGT（5.2～6.8）%、NGT（≤6.0）%,The ROC optimal cut point of DM was 5.9%,with sensitivity of 84%, specificity of 62% and area under the curve of 0.808,The ROC optimal cut point of NGT was 5.6%,with sensitivity of 63%,specificity of 68% and area under the curve of 0.709. In IFG group,significant correlation was found between HbA1c and FPG（r=0.325,P0.01）. Significant correlations were found between HbA1c and 2hPG in IGT group（r=0.275,P0.01）. In NGT group,significant correlations were found between HbA1c and FPG（r=0.207,P0.01）. Conclusions The level of HbA1c represents blood glucose level of different stages of glycometabolism condition

关 键 词：糖尿病 糖尿病前期状态 糖化血红蛋白A1C 

分 类 号：R587.1[医药卫生—内分泌]