Tsuji I, Nakamoto K, Hasegawa T, Hisashige A, Inawashiro H, Fukao A, Hisamichi S
Department of Public Health, Tohoku University School of Medicine, Miyagi, Japan.
Diabetes Care. 1991 Nov;14(11):1075-7. doi: 10.2337/diacare.14.11.1075.
To determine the efficacy of HbA1c and fructosamine as alternatives to fasting plasma glucose (FPG) for diabetes screening.
Receiver operating characteristic (ROC) analysis was conducted on the above tests. Comparison among tests was based on the area under ROC curve of a test. World Health Organization criteria for classifying glucose tolerance status of the subjects was used. The study consisted of subjects (n = 583) who visited the clinic from September to October 1989 and all diabetic cases (n = 36) from November 1989 to March 1990, after excluding those less than 40 yr of age or with hypoglycemic therapies (469 were normal, 88 with impaired glucose tolerance ( IGT], and 62 with diabetes).
Area under ROC curve of HbA1c was not different from that of FPG. Area under curve of fructosamine was significantly smaller than that of FPG. For all tests, overall efficacy of a test to detect IGT and diabetes was considerably diminished compared with detection of diabetes alone.
The discriminating ability of HbA1c is almost the same as that of FPG, therefore HbA1c is a good alternative to FPG. Fructosamine is not suitable for diabetes screening.
确定糖化血红蛋白（HbA1c）和果糖胺作为空腹血糖（FPG）替代指标用于糖尿病筛查的效果。
对上述检测进行受试者操作特征（ROC）分析。检测之间的比较基于一项检测的ROC曲线下面积。采用世界卫生组织对受试者糖耐量状态分类的标准。该研究纳入了1989年9月至10月到门诊就诊的受试者（n = 583）以及1989年11月至1990年3月的所有糖尿病病例（n = 36），排除了年龄小于40岁或接受降糖治疗的患者（469例正常，88例糖耐量受损[IGT]，62例糖尿病）。
HbA1c的ROC曲线下面积与FPG的无差异。果糖胺的曲线下面积显著小于FPG的。对于所有检测，与单独检测糖尿病相比，一项检测检测IGT和糖尿病的总体效果显著降低。
HbA1c的鉴别能力与FPG几乎相同，因此HbA1c是FPG的良好替代指标。果糖胺不适合用于糖尿病筛查。
