Selvin Elizabeth, Zhu Hong, Brancati Frederick L
Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Diabetes Care. 2009 May;32(5):828-33. doi: 10.2337/dc08-1699. Epub 2009 Feb 5.
The purpose of this study was to examine the prevalence and correlates of elevated A1C in a large, nationally representative sample of adults without diabetes in the U.S.
We analyzed data from 15,934 participants aged >or=20 years without diagnosed diabetes who had A1C measurements in the 1999-2006 National Health and Nutrition Examination Survey, a cross-sectional and nationally representative sample of the U.S. population.
The overall prevalence of A1C >6% was 3.8%, corresponding to 7.1 million adults without diabetes in the U.S. population. Approximately 90% of these individuals had fasting glucose >or=100 mg/dl. Older age, male sex, non-Hispanic black race/ethnicity, hypercholesterolemia, higher BMI, and lower attained education were significantly associated with having a higher A1C level even among individuals with normal fasting glucose (<100 mg/dl) and after multivariable adjustment.
A single elevated A1C level (A1C >6%) is common in the general population of adults without a history of diabetes and is highly reliable for the detection of elevated fasting glucose. Nondiabetic adults with elevated A1C are likely to have impaired fasting glucose and an array of other risk factors for type 2 diabetes and cardiovascular disease.
本研究旨在调查美国无糖尿病的成年人群中糖化血红蛋白（A1C）升高的患病率及其相关因素，该样本具有全国代表性且规模较大。
我们分析了来自15934名年龄≥20岁且未被诊断为糖尿病的参与者的数据，这些数据来自1999 - 2006年全国健康与营养检查调查，这是一个美国人口的横断面且具有全国代表性的样本，其中这些参与者均进行了A1C测量。
A1C>6%的总体患病率为3.8%，相当于美国无糖尿病成年人中有710万。这些个体中约90%的空腹血糖≥100mg/dl。即使在空腹血糖正常（<100mg/dl）的个体中，经多变量调整后，年龄较大、男性、非西班牙裔黑人种族/族裔、高胆固醇血症、较高的体重指数（BMI）以及较低的受教育程度与较高的A1C水平显著相关。
单次A1C水平升高（A1C>6%）在无糖尿病病史的成年普通人群中很常见，并且对于检测空腹血糖升高具有高度可靠性。A1C升高的非糖尿病成年人可能存在空腹血糖受损以及一系列其他2型糖尿病和心血管疾病的危险因素。
