Domínguez-Reyes C A, Serrano Carrillo A S, Lozano Soriano I, López Soto J J
Departamento de Medicina Interna, Hospital de Especialidades Miguel Hidalgo, Aguascalientes, México.
Rev Invest Clin. 1999 May-Jun;51(3):175-82.
To evaluate a screening questionnaire to identify individuals with undiagnosed diabetes.
We conducted a community survey to detect people at increased risk for diabetes using a questionnaire proposed by Herman et al. (1995), that incorporates major risk factors as age, obesity, family history of diabetes, sedentary lifestyle and personal history of delivering a macrosomic infant. Blood glucose test was made by means of reagent strip and a reflectance meter system. We used the ADA recommendations and cut-points for screening programs, adjusted for fasting and random blood glucose.
We included 360 participants older than 20 years of age. A total of 200 subjects (55.5%) were at risk for diabetes according to the questionnaire, of whom 31 (15.5%) had an abnormal glucose test compared to the 4.4% of the low-risk group (p < 0.001). The 1995 Herman et al. Questionnaire had sensitivity of 81.6%, specificity of 47.5, positive predictive value of 15.5 and negative predictive value of 95.6%. The high-risk group was older (44.9 vs. 34.6 y, p < 0.001) and heavier (30.5 vs. 24.4 kg/m2, p < 0.001) than the low-risk group. There were 38/360 (10.5%) abnormal glucose readings, of which 31 (81.5%) had a positive questionnaire (p < 0.01). The mean fasting glucose in the high-risk group was higher (90.6 vs. 84.2 mg/dL, p = 0.015) than in those with low risk by questionnaire, as well as for random blood glucose (116.1 vs. 100 mg/dL, p < 0.01).
The questionnaire proposed by Herman et al. combined with capillary blood glucose testing performance good in mexican population to identify people at high risk for undiagnosed diabetes, and improved the detection rate.
评估一份用于识别未确诊糖尿病个体的筛查问卷。
我们采用赫尔曼等人(1995年)提出的一份问卷进行了一项社区调查,以检测糖尿病风险增加的人群,该问卷纳入了年龄、肥胖、糖尿病家族史、久坐不动的生活方式以及分娩巨大儿的个人史等主要风险因素。通过试纸条和反射仪系统进行血糖检测。我们采用了美国糖尿病协会(ADA)针对筛查项目的建议和切点,并对空腹血糖和随机血糖进行了调整。
我们纳入了360名20岁以上的参与者。根据问卷,共有200名受试者(55.5%)有患糖尿病的风险,其中31名(15.5%)血糖检测异常,而低风险组的这一比例为4.4%(p<0.001)。1995年赫尔曼等人的问卷灵敏度为81.6%,特异度为47.5,阳性预测值为15.5,阴性预测值为95.6%。高风险组比低风险组年龄更大(44.9岁对34.6岁,p<0.001)且体重更重(30.5kg/m²对24.4kg/m²,p<0.001)。360人中有38人(10.5%)血糖读数异常,其中31人(81.5%)问卷呈阳性(p<0.01)。高风险组的平均空腹血糖(90.6mg/dL对84.2mg/dL,p=0.015)高于问卷显示的低风险组,随机血糖也是如此(116.1mg/dL对100mg/dL,p<0.01)。
赫尔曼等人提出的问卷结合毛细血管血糖检测在墨西哥人群中识别未确诊糖尿病高风险人群的效果良好,并提高了检测率。