非内分泌科室联合检测糖化血红蛋白与空腹血糖筛查高血糖方法的探讨  

Combined detection of HbA_1c and fasting blood glucose is a better method for screening diabetes in patients of non-endocrinology departments

作　　者：郁新迪[1] 马建华[1] 尹国平[1] 徐小华[1] 江冰[1] 兰洁[1] 陶小军[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)内分泌科,210012

出　　处：《中国糖尿病杂志》2014年第10期917-920,共4页Chinese Journal of Diabetes

摘　　要：目的探讨非内分泌科室联合检测HbA1c与FPG筛查高血糖的最佳方法。方法选取心内科和骨科新入院,且随机血糖≥7.0mmol/L或FPG≥5.0mmol/L的非糖尿病患者,检测FPG、HbA1c、糖化血清蛋白(GA),评估患者糖代谢状态。结果 (1)心内科IGR、糖尿病和糖耐量正常(NGT)者分别为185例、178例、163名,骨科分别为116例、130例、107名。(2)75g OGTT受试者工作特征曲线(ROC)显示,以FPG为诊断糖尿病切点,心内科为5.81mmol/L,骨科为6.24mmol/L;以HbA1c为诊断切点,心内科为6.15%,骨科为5.75%;以GA为诊断切点,心内科为254.50μmol/L,骨科为250.89μmol/L。(3)FPG和HbA1c联合诊断价值与75g OGTT比较有效性更高[曲线下面积(AUC>0.8)]。结论 HbA1c与FPG联合检测能进一步提高非内分泌科住院患者的高血糖筛查效率。Objective To explore a better method for screening diabetes in patients of nonendocrinology departments.Methods The patients in department of cardiology and orthopedics with random blood glucose≥7.0 mmol/L or fasting blood glucose≥5.0 rnmol/L should receive 75 g OGTT,along with HbA1c and glycated albumin（GA）.Results （1）Based on 75 g OGTT,the patients were divided into impaired glucose regulation（IGR）,diabetes mellitus and normal glucose tolerance （NGT） groups.There were 185,178,163 cases in IGR,diabetes mellitus and NGT groups in cardiology department and 116,130,107 cases in orthopedics department.（2）Based on the ROC curve,the optimal cut-point of FPG related to diabetes was 5.81 mmol/L in cardiology department and 6.24 mmol/L in orthopedics department.The cut-point of HbA1c was 6.15％ in cardiology department and 5.75％ in orthopedics department.The cut-point of GA was 254.50 μmol/L in cardiology department and 250.89 μmol/L in orthopedics department.（3）The area under the curve（AUC）was 0.831 of FPG combined with HbA1c which was better than that of OGTT.Conclusion The frequency of disturbed glucose metabolism is considerably high in the non-endocrinology departments.Combined FPG and HbA1c tests are helpful for detecting undiagnosed diabetes.

关 键 词：非内分泌科住院患者 空腹血糖 糖化血红蛋白 糖化血清蛋白 高血糖筛查 

分 类 号：R587.1[医药卫生—内分泌]