Division of Diabetes Translation, National Center for Chronic Disease Prevention and HealthPromotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Xuanping Zhang,
Diabetes Care. 2010 Jul;33(7):1665-73. doi: 10.2337/dc09-1939.
We examined ranges of A1C useful for identifying persons at high risk for diabetes prior to preventive intervention by conducting a systematic review. From 16 included studies, we found that annualized diabetes incidence ranged from 0.1% at A1C <5.0% to 54.1% at A1C >or=6.1%. Findings from 7 studies that examined incident diabetes across a broad range of A1C categories showed 1) risk of incident diabetes increased steeply with A1C across the range of 5.0 to 6.5%; 2) the A1C range of 6.0 to 6.5% was associated with a highly increased risk of incident diabetes, 25 to 50% incidence over 5 years; 3) the A1C range of 5.5 to 6.0% was associated with a moderately increased relative risk, 9 to 25% incidence over 5 years; and 4) the A1C range of 5.0 to 5.5% was associated with an increased incidence relative to those with A1C <5%, but the absolute incidence of diabetes was less than 9% over 5 years. Our systematic review demonstrated that A1C values between 5.5 and 6.5% were associated with a substantially increased risk for developing diabetes.
我们通过系统回顾来研究 A1C 范围，以确定在进行预防性干预之前哪些人具有患糖尿病的高风险。在纳入的 16 项研究中，我们发现糖化血红蛋白（A1C）<5.0%时，糖尿病年发生率为 0.1%，而 A1C≥6.1%时则高达 54.1%。7 项研究对 A1C 广泛范围内的新发糖尿病进行了检测，结果显示：1）A1C 范围内 5.0 至 6.5%之间，风险随着 A1C 的增加而急剧增加；2）A1C 范围在 6.0 至 6.5%之间与发生糖尿病的风险高度增加相关，5 年内的发病率为 25%至 50%；3）A1C 范围在 5.5 至 6.0%之间与相对风险中度增加相关，5 年内的发病率为 9%至 25%；4）A1C 范围在 5.0 至 5.5%之间与 A1C<5%的人相比，发生糖尿病的风险增加，但 5 年内糖尿病的绝对发病率低于 9%。我们的系统回顾表明，A1C 值在 5.5%至 6.5%之间与发生糖尿病的风险显著增加有关。
