糖尿病高风险人群糖化血红蛋白与微血管并发症的关系  

Relationship between HbA1c and microvascular complications in high-risk populations of diabetes

作　　者：彭湘杭[1] 蔡德鸿[1] 杨锐[1] 陆晓和[2] 符敏[2] 艾雅琴[1] 陈宏[1] 张桦[1] 陈容平[1] 

机构地区：[1]南方医科大学附属珠江医院内分泌科,广州510282 [2]南方医科大学附属珠江医院眼科,广州510282

出　　处：《中华内分泌代谢杂志》2011年第5期381-385,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：广东省海珠区科技计划项目（2007-Z-055）

摘　　要：目的 探讨在广州地区的糖尿病高风险人群中HbA1c与糖尿病微血管并发症之间的关系，并评价其对糖尿病的诊断价值。方法对208例糖尿病高风险患者进行HbA1c血精、眼底彩色照相及微量白蛋白尿测定。以受试者工作特征（ROC）曲线比较HbA1c、空腹血糖（FPG）、餐后2hm糖（2hPG）的诊断效果。结果高风险人群中糖尿病视网膜病变患病率为14．9％，微量白赁白尿患病率为12％HbA1c、FPG和2hPG分别为5．8％、7．0mmol／L和10．9mmol／L时视网膜病变的发病率显著增加：HbA1c FPG和2hPG分别为5．8％、6．4mmol／L和107mmol／L时微量白蛋白尿发病率明显增加：结论HbA1c为5．8％时糖尿病高风险人群微血管并发症患病率显著增加，HbA1c和2hPG判断做血管并发症的效果尤明显差异。FPG相对偏低。Objective To explore the association of HbA1c with microvascular complicatinns,and to evaluate the diagnostic value of HbA1c in diabetes mellitus in high-risk populations of Guangzhou. Methods HbA1c, blood glucose, fundus photography, and microalbuminuria were detected in 208 permanent residents with high-risk factors of diabetes. The receiver operating characteristic（ROC） curves were used to estimate the area of HbA1c, fasting plasma glucose （ FPG ） , postprandial 2 h plasma glucose （ 2hPG ） under the crone for discriminating nficrovascular complications. Results There were 14.9% adults suffering from diabetic retinopathy and 12% microalbuminuria in high risk populations of diabetes. The optimal cutoff points of HbA1c, FPG, and 2hPG in detecting retinopathy were 5.8c/c ,7.0 retool/L, and 10.9 mmol/L respectively. The thresholds for increasing prevalence of microalbuminuria were 5.8% for HbA,： ,6.4 mmol/L for FPG, and 10.7 mmol/L fnr 2hPG. Conclusions The prevalence of diabetic microvascular complications increases dramatically at the concentration of HDA1c 5.8%. As a diagnostic value for microvascular complications, there is no significant difference between HbA1c and 2hPG.

关 键 词：糖化血红蛋白 微血管并发症 糖尿病:高风险人群 诊断 

分 类 号：R587.2[医药卫生—内分泌]