中国糖尿病风险评分表在南昌社区中老年人群糖尿病筛查中的运用及改进  

Application and Improvement of Chinese Diabetes Risk Score in Middle-aged and elderly population of Nanchang Community

作　　者：刘媛 霍亚南[2] 熊昌辉 肖妮 熊累累 LIU Yuan;HUO Yanan;XIONG Changhui(The People’s Hospital of Ganzhou,Ganzhou,341000;Jiangxi Provincial People’s Hospital,Nanchang,330006,China.)

机构地区：[1]江西省赣州市人民医院,赣州341000 [2]江西省人民医院,南昌330006

出　　处：《江西医药》2019年第1期3-7,14,共6页Jiangxi Medical Journal

基　　金：科技部重大新药创制项目;编号2012ZX09303006-001

摘　　要：目的探讨中国糖尿病风险评分表在南昌社区中老年人群糖尿病筛查中的运用效果及改进。方法对纳入的南昌15个社区,年龄40-74岁8714人,进行问卷调查、体格检查及生化检测,分别采用中国糖尿病风险评分表及其改进表(在中国糖尿病风险评分表中用颈围替换腰围构建的预测模型⑴在中国糖尿病风险评分表中加入颈围构建的预测模型⑵筛查入选人群,并用口服葡萄糖耐量试验(OGTT)作为诊断糖尿病的金标准,用受试者工作曲线对3种方法进行比较。结果 3种方法评估糖尿病发生风险的AUC分别为0.781(95%CI 0.772-0.790)、0.791(95%CI 0.783-0.800)、0.772(95%CI 0.763-0.780),三种方法最佳切点,及其灵敏度和特异度分别为25分86.5%、49.5%,28分、71.5%、70.9%,35分、71.3%和68.9%,3种方法ROC曲线下面积比较,差异均有统计学意义,且预测模型1>中国糖尿病风险评分表>预测模型2。结论中国糖尿病风险评分表适用于南昌社区中老年人群的糖尿病风险筛查,颈围替换评分表中的腰围可以提高筛查效果。Objective To explore the application effect and improvement of Chinese Diabetes Risk Score in the middle-aged and elderly population in Nanchang community.Methods The questionnaires,physical examinations,and biochemical tests were conducted among 15 communities 8714 people in Nanchang,aged 40-74 years old.Chinese diabetes risk score and Improved diabetes risk score(Predictive model 1 constructed by replacing the waist circumference with neck circumference in the Chinese Diabetes Risk Score Table.Predictive model 2 constructed by neck circumference in the Chinese Diabetes Risk Score Table)were used to screen all selected people.The Oral glucose tolerance test(OGTT)was used as the gold standard for the diagnosis of diabetes.the Area under the receiver operating curve(AUC)of the three methods at the best cut-0ff point were calculated and compared.Results The AUC of the three methods for assessing the risk of diabetes was 0.781(95%CI 0.772 to 0.790),0.791(95%CI 0.783 to 0.800)and 0.772(95%CI 0.763~0.780)respectively,The sensitivity and specificity were 25 points,86.5%,49.5%,28 point,71.5%,70.9%,35 point,71.3%,68.9%,respectively.The AUC of the three methods were statistically significant,and the prediction model 1 >Chinese Diabetes Risk Score >Predictive Model 2.Conclusion The Chinese Diabetes Risk Score apply to diabetes risk screening in the middle-aged and elderly population in Nanchang community.by replacing the waist circumference with the neck circumference In The Chinese Diabetes Risk Score may improve the screening effect.

关 键 词：2型糖尿病 糖尿病风险评分 筛查 颈围 

分 类 号：R587.1[医药卫生—内分泌]