【摘要】：目的:通過Hb A1c在西寧地區(qū)漢族人群中對DM診斷的研究,探討是否存在更合適于該地區(qū)人群診斷DM的Hb A1c切點(diǎn)值。方法:選取在2014年12月~2016年12月期間西寧地區(qū)漢族在青海大學(xué)附屬醫(yī)院住院部未明確DM或DM高危人群,共565名,男性319人,女性246人,平均年齡57±14歲。對受檢人群行OGTT試驗(yàn),并測定Hb A1c。以O(shè)GTT為診斷DM的金標(biāo)準(zhǔn),用SPSS軟件繪制ROC曲線確定診斷DM的最佳Hb A1c切點(diǎn)值。結(jié)果:(1)本研究按1999年WHO診斷DM的標(biāo)準(zhǔn),所有入組的研究人群中NGT、IGR、DM者分別有233例、103例、229例。(2)西寧地區(qū)漢族診斷DM最佳切點(diǎn)為6.35%,其曲線下面積為94.0%(95%CI 0.92~0.96),SE 86.9%,SPE 86.9%,PPV 81.5%,NPV 90.7%,PLR 6.63,NLR 0.15。(3)Hb A1c切點(diǎn)值為6.35%的SE高于Hb A1c≥6.5%和FPG≥7.0mmol/L(86.9%84.3%65.1%)。(4)分別以Hb A1c≥6.35%和Hb A1c≥6.5%作為本研究所有被檢者診斷DM的標(biāo)準(zhǔn)時,其檢測是否為DM的結(jié)果不同,差異有統(tǒng)計學(xué)意義(P=0.031)。(5)Hb A1c 6.35%和6.5%兩個不同切點(diǎn)值檢測否為DM的結(jié)果經(jīng)Kappa一致性檢驗(yàn),有很高的一致性(Kappa指數(shù)=0.977)。(6)RBC、HGB在DM組中的水平均高于IGR組和NGT組(P0.05)。結(jié)論:(1)在本研究中,西寧地區(qū)漢族人群Hb A1c診斷DM的最佳切點(diǎn)為6.35%。(2)當(dāng)不能檢測FPG或者FPG不能真實(shí)反應(yīng)即時血糖時,可參考Hb A1c的檢測結(jié)果。
[Abstract]:Objective: to study the diagnosis of DM in Xining Han population by HbA1c, and to explore whether there is a better value of HbA1c in the diagnosis of DM in Xining. Methods: from December 2014 to December 2016, a total of 565 subjects (319 males and 246 females) with an average age of 57 鹵14 years, were selected from the inpatient department of Xining University affiliated Hospital of Qinghai University in Xining, with a total of 565 persons (319 males and 246 females) who had no definite risk of diabetes mellitus (DM) or diabetes mellitus (DM). OGTT test was performed and HB A 1c was determined. With OGTT as the gold standard for the diagnosis of DM, the best HbA1c tangent value was determined by drawing the ROC curve with SPSS software. Results: (1) according to the criteria of WHO diagnosis of DM in 1999, There were 233 patients with NGT IGR DM and 229 patients with NGT IGR DM. (2) in Xining Han nationality, the best point of DM diagnosis was 6.35. The area under the curve was 94.0% (95%CI 0.920.96). The area under the curve was 94.0% (95%CI 0.920.96). The area under the curve was 94.0% (95%CI 0.920.96). The area under the curve was 94.0% (95%CI 0.92 鹵0.96), and PPV81.55.The cut point of HbA1c 鈮，

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