口服葡萄糖耐量试验1h血糖对糖尿病前期的诊断和鉴别价值  

Diagnosis and differentiation value of 1 hour blood glucose during oral glucose tolerance test for prediabetes

作　　者：韩福禄[1] 姚兴伟[2] 栗晓彬 李洪敏 张梅[2] 武玉鑫 宋天佳 杨琦[2] 刘尚建[2] HAN Fulu;YAO Xingwei;LI Xiaobin;LI Hongmin;ZHANG Mei;WU Yuxin;SONG Tianjia;YANG Qi;LIU Shangjian(Medical Clinical Lab,Hospital of Renmin University of China,Beijing 100872;Medicine Clinical Lab,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,Beijing 100700)

机构地区：[1]中国人民大学医院检验科,北京100872 [2]北京中医药大学东直门医院检验科,北京100700

出　　处：《郑州大学学报（医学版）》2024年第2期201-205,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家重点研发计划“中医药现代化研究”重点专项(2019YFC1710101);北京中医药大学东直门医院科技创新专项(DZMKJCX-2022-004)。

摘　　要：目的:探讨口服葡萄糖耐量试验(OGTT)1 h血糖对糖尿病前期的诊断和鉴别价值。方法:收集2019年6月至2022年6月于北京中医药大学东直门医院门诊及住院行OGTT的受试者1 206例,其中血糖正常412例,糖尿病前期358例,糖尿病436例。比较3组OGTT不同时点血糖与空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌功能指数(HOMA-β)水平;采用ROC曲线分析OGTT 1 h血糖对糖尿病前期的诊断和鉴别价值。结果:3组OGTT各时点血糖均为糖尿病组>糖尿病前期组>血糖正常组(P<0.05)。FPG、HOMA-IR糖尿病组>糖尿病前期组>血糖正常组,FINS、HOMA-β糖尿病组<糖尿病前期组<血糖正常组(P<0.05)。ROC曲线分析结果显示,OGTT 1 h血糖诊断糖尿病前期的AUC(95%CI)为0.758(0.724~0.792),以敏感度最大选取最佳切点值,该值为9.35 mmol/L,此时敏感度为0.701,特异度为0.709;OGTT 1 h血糖对糖尿病和糖尿病前期鉴别的AUC(95%CI)为0.956(0.942~0.969),以敏感度最大选取最佳切点值,该值为12.55 mmol/L,此时敏感度为0.901,特异度为0.908。结论:OGTT 1 h血糖对糖尿病前期具有一定的诊断和鉴别价值。Aim:To explore the diagnosis and differentiation value of 1 hour blood glucose during oral glucose tolerance test(OGTT)for prediabetes.Methods:A total of 1206 subjects who underwent OGTT as outpatients and inpatients at Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from June 2019 to June 2022 were collected;among them,412 cases had normal blood glucose,358 cases were prediabetes,and 436 cases were diabetes.The blood glucose levels at different time points of OGTT,fasting plasma glucose(FPG),fasting insulin(FINS),homeostasis model assessment insulin resistance index(HOMA-IR),and homeostasis model assessment homa isletβcell function index(HOMA-β)of the 3 groups were observed and compared.The diagnosis and differentiation values of OGTT 1 hour blood glucose for prediabetes were analyzed by ROC curve.Results:The blood glucose at each time point of OGTT in the 3 groups were diabetes group>prediabetes group>normal group(P<0.05).FPG and HOMA-IR were diabetes group>prediabetes group>normal group(P<0.05),and FINS and HOMA-βwere diabetes group<prediabetes group<normal group(P<0.05).AUC(95%CI)of OGTT 1 hour blood glucose for diagnosis of prediabetes was 0.758(0.724-0.792),the best cut-off value was 9.35 mmol/L selected with the highest sensitivity,and the sensitivity was 0.701 and the specificity was 0.709;AUC(95%CI)for the differentiation of diabetes and prediabetes was 0.956(0.942-0.969),the best cut-off value was 12.55 mmol/L selected with the highest sensitivity,and the sensitivity was 0.901 and specificity was 0.908.Conclusion:OGTT 1 hour blood glucose is of some diagnosis and differentiation value for prediabetes.

关 键 词：糖尿病 糖尿病前期 口服葡萄糖耐量试验1 h血糖 

分 类 号：R587.1[医药卫生—内分泌]