糖化血红蛋白和空腹血糖筛查体检人群血糖状态的差异性分析  

Analysis of discordance between HbA1c and FPG criteria for dysglycemia screening in physical examination individuals

作　　者：冯晓晶 杨燕怡 方奕元 庄思琪 戴钰丰 唐玲丽[1] 唐浩能[1] Feng Xiaojing;Yang Yanyi;Fang Yiyuan;Zhuang Siqi;Dai Yufeng;Tang Lingli;Tang Haoneng(Department of Laboratory Medicine,the Second Xiangya Hospital,Central South University,Changsha 410011,China;Health Management Center,the Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院检验医学科,长沙410011 [2]中南大学湘雅二医院健康管理中心,长沙410011

出　　处：《中华预防医学杂志》2021年第6期780-785,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金 (81600666)。

摘　　要：本研究为横断面研究,收集2019年1至12月在中南大学湘雅二医院健康管理中心进行健康体检的11922名体检者的一般资料、血常规、肝肾功能、糖代谢和脂代谢等指标。根据HbA1c和FPG两种指标,对其血糖状态进行分类,通过多因素logistic回归模型分析影响筛查结果不一致的主要因素。采用HbA1c筛查糖尿病和糖尿病前期的人群比例(分别为8.13%,34.79%)均明显高于FPG(分别为4.70%,8.97%)(χ^(2)值=2635.940,P<0.001),两种指标筛查糖代谢异常不一致的人群比例为35.65%,并主要集中于HbA1c为5.7%~6.0%且FPG<5.6 mmol/L的人群,其次为HbA1c为6.1%~6.4%且FPG<5.6 mmol/L的人群,不一致人群比例在男性和女性中均随年龄的增加而增加。导致不一致现象的主要因素包括年长、超重或肥胖、低白蛋白血症、血脂紊乱和高尿酸血症等,其中45岁以上人群(OR=3.525,95%CI:3.216~3.863,P<0.001)相比45岁以下人群,超重(OR=1.474,95%CI:1.341~1.620,P<0.001)或肥胖人群(OR=1.856,95%CI:1.633~2.110,P<0.001)相比于体重正常人群,均更容易出现筛查不一致的现象。The general data,blood routine,liver and kidney function,glucose metabolism and lipid metabolism of 11922 participants who underwent physical examination at the Health Management Center of the Second Xiangya Hospital of Central South University from January 2019 to December 2019 were collected.Clinical characteristics and independent factors of patients with discordance between HbA1c and FPG were evaluated and analyzed.The prevalence of HbA1c-defined diabetes and prediabetes(respectively 8.13%,34.79%)were significantly higher than that in FPG-defined diabetes and prediabetes(respectively 4.70%,8.97%)(χ^(2)=2635.940;P<0.001).The prevalence of inconsistence between HbA1c and FPG was 35.65%and increased with increasing age.This inconsistence mainly occurred in population with HbA1c:5.7%-6.0%and FPG<5.6 mmol/L,followed by population with HbA1c:6.1%-6.4%and FPG<5.6 mmol/L.The risk factors of inconsistency included advanced age,overweight or obesity,hypoalbuminemia,dyslipidemia and hyperuricemia.Among these special participants,compared with participants under 45 years old,participants with over 45 years of age(OR=3.525,95%CI:3.216-3.863,P<0.001)were more likely to have inconsistence between HbA1c and FPG;and overweight participants(OR=1.474,95%CI:1.341-1.620,P<0.001)or obese participants(OR=1.856,95%CI:1.633-2.110,P<0.001)are prone to have the inconsistence than those with normal weight.

关 键 词：糖化血红蛋白 血糖 糖代谢异常 年龄 肥胖 

分 类 号：R587.1[医药卫生—内分泌]