糖化血红蛋白用于筛查糖尿病及糖耐量受损的研究  

HbA1c as a screening test for diabetes mellitus and impaired glucose tolerance

作　　者：艾雅琴[1] 刘泽林[1] 孙玲[1] 涂云明[1] 章志[1] 曾竹青[1] 邹从[1] 

机构地区：[1]南昌大学第四附属医院内分泌科,南昌330000

出　　处：《江西医药》2011年第3期212-214,共3页Jiangxi Medical Journal

摘　　要：目的评估糖化血红蛋白(HbA1c)在筛查2型糖尿病(T2DM)及糖耐量减低(IGT)中的应用价值。方法对658例研究对象行口服糖耐量试验(OGTT)并测定HbA1c、血脂4项。结果采用受试者工作特征曲线(ROC)判断。当筛查T2DM时,HbA1c切点为5.8%,灵敏度和特异度分别为74.36%和81.55%,曲线下面积0.847,阳性预测值为45.22%,阴性预测值为93.95%,阳性似然比4.031,阴性似然比0.314。当同时筛查T2DM和IGT时,HbA1c切点为5.9%,灵敏度和特异度分别为38.86%和93.27%,曲线下面积0.697,阳性预测值为85.25%,阴性预测值为60.41%,阳性似然比5.778,阴性似然比0.655。结论HbA1c≥5.8%时应进一步行OGTT以明确有无DM,HbA1c不适用于同时筛查T2DM和IGT人群。Objective To assess the validity of using HbA1c for the screening of type 2 diabetes（T2DM） and impaired glucose tolerance（IGT）.Methods We took oral glucose tolerance test（OGTT） and examined HbA1c and blood lipids from 658 subjects.Results Using a receiver operating characteristic curve（ROC）,the optimal cut-point of HbA1c related to T2DM diagnosed by OGTT was 5.8% that was associated with a sensitivity and specificity of 74.36% and 81.55%.Area under the curve（AUC） was 0.847,a positive predictive value（PPV） was 45.22%,a negative predictive value（NPV） was 93.95%,a positive likelihood ratio（LR＋） was 4.031,a negative likelihood ratio（LR-） was 0.314.The optimal cut-point of HbA1c related to T2DM and IGT diagnosed by OGTT was 5.9% that was associated with a sensitivity and specificity of 38.86% and 93.27%.AUC was 0.697,a PPV was 85.25%,a NPV was 60.41%,a LR＋ was 5.778,a LR-was 0.655.Conclusion When HbA1c≥5.8%,OGTT was necessary to confirm the diagnosis of diabetes.HbA1c was not reliable to identify T2DM and IGT.

关 键 词：糖化血红蛋白 2型糖尿病 糖耐量减低 筛查 

分 类 号：R587.1[医药卫生—内分泌]