Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
Diabet Med. 2009 Dec;26(12):1262-8. doi: 10.1111/j.1464-5491.2009.02831.x.
To determine the performance of glycated haemoglobin (HbA(1c)) as a screening tool for detecting newly diagnosed diabetes (NDM) and pre-diabetes.
A diabetes survey was conducted in Beijing among community dwellers who were willing to participate in the survey. Included in the survey were 903 individuals aged 21-79 years without previously diagnosed diabetes and in whom HbA(1c) and other required covariates had been measured. NDM and pre-diabetes (impaired glucose tolerance + impaired fasting glucose) were defined according to the World Health Organization 1999 criteria based on 75-g oral glucose tolerance test. Receiver operating characteristic curve (ROC) was plotted to determine the performance of HbA(1c).
The prevalence of NDM and pre-diabetes was 11.1% and 22.4%, respectively. At an optimal HbA(1c) cut-off point of > or = 6.0%, the test gave a sensitivity of 80.0% and a specificity of 89.8% for diagnosing NDM; at an optimal cut-off point of > or = 5.7%, the sensitivity was 59.4% and specificity 73.9% for diagnosing pre-diabetes. Individuals with HbA(1c)> or = 6.0% tended to be more obese than those with HbA(1c) < 6.0%, but blood pressure and lipid profiles did not differ between the two groups.
HbA(1c) as a single screening test is adequate to detect newly diagnosed diabetes but is not able to identify pre-diabetes in this obese Chinese population.
评估糖化血红蛋白（HbA1c）作为筛查工具检测新诊断糖尿病（NDM）和糖尿病前期的性能。
在北京进行了一项糖尿病调查，参与者为愿意参加调查的社区居民。调查包括 903 名年龄在 21-79 岁之间、无既往诊断糖尿病且已测量 HbA1c 和其他必需协变量的个体。根据基于 75g 口服葡萄糖耐量试验的 1999 年世界卫生组织标准，将 NDM 和糖尿病前期（糖耐量受损+空腹血糖受损）定义为。绘制受试者工作特征曲线（ROC）以确定 HbA1c 的性能。
NDM 和糖尿病前期的患病率分别为 11.1%和 22.4%。在最佳 HbA1c 截断点>或=6.0%时，该检测对 NDM 的诊断敏感性为 80.0%，特异性为 89.8%；在最佳截断点>或=5.7%时，对糖尿病前期的诊断敏感性为 59.4%，特异性为 73.9%。HbA1c>或=6.0%的个体往往比 HbA1c<6.0%的个体更肥胖，但两组之间的血压和血脂谱没有差异。
HbA1c 作为单一筛查试验足以检测新诊断的糖尿病，但不能在该肥胖中国人群中识别糖尿病前期。
