血清糖基化终产物-肽在社区糖尿病高危人群中的筛查价值  

Value of serum advanced glycation end products-peptide in the screening of diabetes mellitus in acommunity-based population of high-risk diabetics

作　　者：谢作玲[1] 张林[1] 王艳萍[1] 贺佳佳[1] 周祎[1] 雷程灏[1] 邱山虎[1] 孙子林[1] 

机构地区：[1]东南大学医学院东南大学糖尿病研究所东南大学附属中大医院内分泌科,南京210009

出　　处：《中华医学杂志》2012年第40期2843-2846,共4页National Medical Journal of China

基　　金：江苏省科学技术厅自然科学基金（BK2010087）

摘　　要：目的探讨血清糖基化终产物-肽（AGE-P）在社区糖尿病高危人群中的筛查价值。方法2011年1至10月收集社区糖尿病高危人群857例，进行75g口服葡萄糖耐量试验（OGTr），测定空腹血糖（FBG）、餐后2h血糖（2hPG）及糖化血红蛋白（HbAlc），并留取血标本采用流动注射分析技术测定血清AGE．P值。利用受试者工作特征（ROC）曲线探讨血清AGE—P的筛查价值，并利用相关分析研究其与FBG、2hPG、HbAlc等指标之间的相关性。结果（1）根据2010年美国糖尿病协会糖尿病诊断标准，共筛选出糖尿病患者218例。（2）血清AGE-P诊断糖尿病的最佳切点为10．22mg／L（峰值25．39mm），敏感度为84．1％，特异度为88．3％；阳性预测值为71％。（3）血清AGE．P、FBG、2hPG和HbAlC诊断糖尿病的ROC曲线下面积（AUC）分别为0．924、0．905、0．951和0．874；组间血清AGE-P与HbAlC比较，AUC值差异有统计学意义（P〈0．025）；血清AGE·P与FBG、2hPG比较，AUC值差异均无统计学意义（均P〉0．025）。（4）相关分析显示，血清AGE-P与HbAlc、FBG、2hPG均呈正相关（均P〈0．05）。结论血清AGE-P可用于社区糖尿病高危人群筛查，其筛查价值优于HbAlC。Objective To explore the value of serum advanced glycation end productspeptide （AGE-P） in the screening of diabetes mellitus in a communitybased population of highrisk diabetics. Methods A total number of 857 adult highrisk diabetics from a communitybased population underwent 75 g oral glucose tolerance test （OGTT）. Blood samples were drawn to measure the levels of fasting blood glucose （FBG）, postprandial blood glucose （2 hPG） and glycosylated hemoglobin Alc（HhAlc）. And blood samples were also collected to determine the serum level of AGE-P with the technique of flow injection analysis. Receiver operating characteristic （ROC） curve was plotted to assess the screening value of serum AGE-P in diabetes mellitus. Pearson correlation analysis was conducted to evaluate the association between serum AGE-P and FBG, 2 hPG, HbAlc, body mass index （BMI）, waist-to-hip ratio （WHR） and age. Results Among them, 218 adults were diagnosed with diabetes based on the 2010 American Diabetes Association （ADA） criteria. According to the ROC curve, the optimal cut-point of serum AGE-P for diagnosing diabetes was 10. 22 mg/L （a peak height of 25.39 mm） with sensitivity of 84. 1% , specificity of 88.3 % and positive predictive value of 71%. The area under curve （AUC） of serum AGE-P, FBG, 2 hPG and HbAlc for diagnosing diabetes was 0. 924, 0. 905, 0. 951 and 0. 874 respectively. When comparing AUC between serum AGE-P and HbAlc, FBG and 2 hPG, statistical significance was only found in the comparisons between serum AGE-P and HbAlc （ P 〈 O. 025 ）. Pearson correlation analysis showed that serum AGE-P was highly positively correlated with HhAlc, significantly positively correlated with FBG and 2 hPG and slightly positively correlated with WHR and age （ all P 〈 O. 05 ）. But there was no correlation with BMI. Conclusions Serum AGE-P may be used for the screening of diabetes in the communitybased population of highrisk diabetics. And it is even superior to HbAlc.

关 键 词：糖尿病 普查 糖基化终产物-肽 

分 类 号：R587.1[医药卫生—内分泌]