Melbourne Pathology Services, Melbourne, Australia.
Diabetes Care. 2010 Apr;33(4):817-9. doi: 10.2337/dc09-1763. Epub 2010 Jan 12.
To evaluate A1C for screening and diagnosis of undiagnosed type 2 diabetes defined by oral glucose tolerance testing in clinical and general populations.
A1C cut offs (< or =5.5% to rule out diabetes; > or =7.0% to rule in diabetes) were derived from a clinical group (Melbourne Pathology [MP] group: n = 2,494; undiagnosed diabetes 34.6%) and then evaluated in a population-based sample (AusDiab group: n = 6,015; undiagnosed diabetes 4.6%).
For diabetes in the MP and AusDiab groups, A1C at 5.5% gave sensitivities of 98.7 and 83.5%, while A1C at 7.0% gave specificities of 98.2 and 100%, respectively. Many (61.9-69.3%) with impaired A1C (5.6-6.9%) in both populations had abnormal glucose status.
A1C < or =5.5% and > or =7.0% predicts absence or presence of type 2 diabetes, respectively, while at A1C 6.5-6.9% diabetes is highly probable in clinical and population settings. A high proportion of people with impaired A1C have abnormal glucose status requiring follow-up.
评估 A1C 在临床和普通人群中用于筛查和诊断口服葡萄糖耐量试验定义的未确诊 2 型糖尿病的作用。
A1C 切点（<或=5.5%排除糖尿病；>或=7.0%诊断糖尿病）源自临床组（墨尔本病理学[MP]组：n=2494；未确诊糖尿病 34.6%），然后在基于人群的样本（AusDiab 组：n=6015；未确诊糖尿病 4.6%）中进行评估。
对于 MP 和 AusDiab 组的糖尿病，A1C 为 5.5%时的敏感性分别为 98.7%和 83.5%，而 A1C 为 7.0%时的特异性分别为 98.2%和 100%。在这两个人群中，许多（61.9-69.3%）A1C 受损（5.6-6.9%）的人血糖状态异常。
A1C <或=5.5%和>或=7.0%分别预测 2 型糖尿病的不存在或存在，而在 A1C 6.5-6.9%时，临床和人群环境中糖尿病的可能性非常高。许多 A1C 受损的人血糖状态异常，需要随访。
