青岛糖尿病危险评分表筛查2型糖尿病效果评价  

Efficacy of Qingdao diabetes risk score in type 2 diabetes mellitus screening among asymptomatic adult populations

作　　者：曹怡[1] 宁锋[2] 孙健平[2] 崔静[2] 李晓静[2] 逄增昌[2] 

机构地区：[1]青岛大学医学院公共卫生系,山东青岛266021 [2]青岛市疾病预防控制中心

出　　处：《中国公共卫生》2016年第7期903-906,共4页Chinese Journal of Public Health

基　　金：世界糖尿病基金会(WDF07-308)

摘　　要：目的 评价青岛糖尿病危险评分表（QDRS）筛查2型糖尿病（T2DM）的效果,为T2DM的预防控制提供参考依据。方法 对山东省青岛市2009年糖尿病项目中自报无T2DM的4 426人进行口服葡萄糖耐量试验（OGTT）,于2012年对其中3 843名未患T2DM者进行随访调查,通过构建受试者工作特征曲线（ROC）模型,比较QDRS与空腹血浆血糖（FPG）和中国糖尿病危险评分表（CDRS）筛查无症状T2DM人群的灵敏度、特异度和约登指数,并在2 295名3年随访人群中验证该工具的可靠性。结果 青岛市2009年4 426名基线人群的T2DM发病率为13.2%,2012年2 295名随访人群的T2DM发病率为7.9%;2009年FPG、QDRS和CDRS筛查T2DM的曲线下面积（AUC）分别为0.87（95%CI=0.85~0.89）、0.68（95%CI=0.66~0.70）和0.70（95%CI=0.68~0.72）,最佳切点（FPG≥6.4 mmol/L、QDRS≥14分和CDRS≥30分）的灵敏度分别为72.0%、73.2%和66.2%,特异度分别为91.2%、66.5%和63.8%,约登指数分别为0.63、0.30和0.30;2012年FPG、QDRS和CDRS筛查T2DM的AUC分别为0.83（95%CI=0.79~0.87）、0.62（95%CI=0.57~0.66）和0.65（95%CI=0.61~0.70）,最佳切点的灵敏度分别为51.7%、75.6%和73.8%,特异度分别为95.7%、41.0%和47.9%,约登指数分别为0.47、0.12和0.21;2009年和2012年QDRS与FPG、CDRS预测新发糖尿病效能比较,差异均无统计学意义（均P〉0.05）。结论QDRS可以作为预测T2DM人群的可靠筛查工具。Objective To evaluate the efficacy of Qingdao diabetes risk score （QDRS） in type 2 diabetes mellitus （T2DM） screening among symptomatic adult residents and to provide references for T2DM prevention and control. Methods A diabetes control project was conducted among 4 426 self-assessed healthy persons aged 35 -74 years in Qingdao city of Shandong province; questionnaire surveys including Chinese diabetes risk score （ CDRS ）, QDRS and a general questiormalre,physical examination, and laboratory test including oral glucose tolerance test （OGTr） and fasting plasma glucose （FPG） were performed among the attendees of the project. Then a follow-up study the same as the previ- ous project was conducted in 2012 among 3 843 attendees who were not diagnosed with T2DM in 2009 ,of which ,2 295 were followed up finally. Receiver operating characteristic （ROC） curve was constructed and the sensitivity, specificity, and Youden indexe were calculated for QDRS, CDRS, and FPG to evaluate the efficacy of the indexes in screening asymptomatic diabetes. Results The detection rate of T2DM was 13.2% among the 4 426 participants of the survey in 2009 and 7.9% among the 2 295 participants of follow-up study in 2012. Based on the data of 2009 survey, the area under the ROC curve （AUC） of FPG, QDRS, and CDRS for T2DM detection were 0. 87 （95% confidence interval E95% C1] =0. 85 -0. 89） ,0. 87 （95% CI=0. 85 -0. 89） ,and 0.70 （95% CI =0. 68 -0. 72） ;the sensitivity and speci- ficity of the optimal cut-off value of FPG （ ≥ 6. 4 mmol/L）, QDRS （ ≥ 14 points ）, and CDRS （ ≥ 30 points ） were 72.0% and 91.2% ,73.2% and 66. 5% ,and 66. 2% and 63.8% ,respectively;the Youden＇ index for FPG,QDRS,and CDRS were 0. 63,0. 30,and 0. 30. Based on the data of 2012 follow-up study,the AUC of FPG,QDRS,and CDRS were 0. 83 （95 % CI = 0. 79 - 0. 87 ）, 0. 62 （ 95 % CI = 0. 57 - 0. 66 ）, and 0.65 （ 95 % CI = 0. 61 - 0.70） ; the sensitivity and specificity of the optimal cut-off value of FPG, QDR

关 键 词：2型糖尿病(T2DM) 筛查 糖尿病危险评分表 受试者工作特征曲线(ROC) 

分 类 号：R587.1[医药卫生—内分泌]