两种糖尿病风险量表筛查糖尿病及糖调节受损效果评价  

Evaluation on screening effects of diabetes mellitus and impaired glucose regulation for two diabetes screening questionnaires

作　　者：李璐[1] 胡世莲[2] 洪海鸥[1] 梅涛[1] 叶山东[3] 邢燕[3] 

机构地区：[1]安徽省立医院健康管理中心,安徽省合肥230001 [2]安徽省立医院安徽省老年医学研究所 [3]安徽省立医院内分泌科

出　　处：《中国慢性病预防与控制》2015年第4期256-258,262,共4页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的评估丹麦糖尿病风险评分量表（DDRS）及中国糖尿病风险评分量表（CDRS）在健康体检人群中筛查糖尿病及糖调节受损的效果，为更有效提高两种疾病筛查效率提供依据。方法选择安徽省立医院参加2014年健康体检的在职职工为研究对象，从2093名体检及问卷信息完整的人员中提取相应信息，分别构建两种风险评分量表的受试者工作特征（ROC）曲线，比较使用不同风险评分量表筛查新诊断糖尿病及糖调节受损人群的敏感度、特异度、约登指数及ROC曲线下面积（AUC）。结果2093名体检人员中，新诊断糖尿病患者23例，糖调节受损患者59例。DDRS和CDRS筛查新诊断糖尿病的AUC分别为0．87（95％CI：0．82-0．93）和0．89（95％CI：0．84～0．95），使用原切点时（DDRS为≥31分，CDRS为≥25分），两者的敏感度分别为43．48％和78．26％，特异度分别为94．83％和82．66％，约登指数分别为0．38和0．61。但在本研究中使用时，DDRS及CDRS的最佳切点分别为≥19分和≥20分，较原文献报道情况均有所下降。筛查糖调节受损时，DDRS与CDRS的AUC分别为0．74（95％Ch0．67-0．81）和0．80（95％Ch0．74-0．86），最佳切点分别为≥16分和I〉20分，DDRS的敏感度、特异度、约登指数分别为67．20％、71．70％和O．39，CDRS分别为81．25％、71．17％和0．52。结论两种风险评分工具均可应用于健康体检人群的新诊断糖尿病及糖调节异常筛查，总体上说，CDRS各评价指标优于DDRS。Objective To evaluate the screening effects of diabetes mellitus and impaired glucose regulation （IGR） for Dannish Diabetes Risk Scores （DDRS） and Chinese Diabetes Risk Scores （CDRS） in health population and to provide the base for increase of the screening effects. Methods The objects of present investigation were 2 093 employees with physical examination and questionnaire information in 2014. The receiver-operating characteristic curves （ROC） were established with DDRS and CDRS. The sensitivity, the specificity, Youden＇ index and the area under curve （AUC） of ROC of DDRS and C DRS were compared for screening DM and IGR. Results In 2 093 subjects, 23 cases were newly diagnosed DM and 59 cases were newly diagnosed IGR. For predicting DM, the AUC of newly diagnosed DM were 0.87 （95%C1： 0.82-0.93） for DDRS and 0.89 （95%CI： 0.84-0.95） for CDRS, respectively; at the original cutoffvalue （DDRS≥31 and CDRS≥25）, the sensitivity of DDRS and CDRS was 43.48% and 78.26%, the specificity of DDRS and CDRS was 94.83% and 82.66%, and Youden＇ indexes of DDRS and CDRS were 0.38 and 0.61; but the optimal cutoff values of DDRS and CDRS in present investigation were ≥ 19 and t〉 20, which were lower than those （≥ 31 and ≥ 25 ） of original article. For predicting IGR, the AUC of DDRS and CDRS were 0.74 （95%CI： 0.67-0.81 ） and 0.80 （95%C1： 0.74- 0.86）. The optimal cutoff values of DDRS and CDRS were ≥ 16 and 〉120, respectively. The sensitivity, the specificity and Youden＇ index of DDRS were 67.20%, 71.70% and 0.39, respectively. The sensitivity, the specificity and Youden＇ index of CDRS were 81.25%, 71.17% and 0.52, respectively. Conclusion The two questionnaires can be used to screen DM and IGR in health population. In general, the evaluation indexes of CDRS are better than those of DDRS.

关 键 词：糖尿病 糖调节受损 筛查 量表 受试者工作特征曲线 

分 类 号：R587.1[医药卫生—内分泌]