糖化血红蛋白与口服葡萄糖耐量试验在排除高危个体糖耐量受损中的比较。

Glycated hemoglobin vs. the oral glucose tolerance test for the exclusion of impaired glucose tolerance in high-risk individuals.

机构信息

Clinical Biochemistry Department, Virgen Macarena University Hospital, Sevilla, Spain.

出版信息

Clin Chem Lab Med. 2010 Dec;48(12):1719-22. doi: 10.1515/CCLM.2010.338. Epub 2010 Sep 17.

DOI:10.1515/CCLM.2010.338

PMID:20846105

Abstract

BACKGROUND

The aim of this study was to compare the use of glycated hemoglobin (HbA(1c)) and the oral glucose tolerance test (OGTT) in the diagnosis of impaired glucose tolerance in high-risk individuals.

METHODS

A total of 713 patients with at least two risk factors for the development of type 2 diabetes were enrolled in the study. Fasting glucose and HbA(1c) were measured in all individuals. Patients whose fasting glucose concentrations were below 7.0 mmol/L underwent an OGTT.

RESULTS

From the 713 patients, 234 were euglycemic, 200 had impaired fasting glucose, 118 presented with impaired glucose tolerance and 161 met the diagnostic criteria for type 2 diabetes. OGTT was performed in a total of 596 patients (83.6%). Statistically significant differences were observed for HbA(1c) concentrations in all groups. Receiver operating characteristic curve analysis was performed to assess the capability of HbA(1c) to discriminate between normal glucose tolerance and impaired glucose tolerance. An HbA(1c) value of 36 mmol/mol (5.4%) gave an optimal sensitivity of 85% and a specificity of 73%, and a negative predictive value of 97% for identifying patients with impaired glucose tolerance.

CONCLUSIONS

HbA(1c) can be used to rule out patients at high-risk of developing type 2 diabetes.

摘要

背景

本研究旨在比较糖化血红蛋白（HbA(1c)）和口服葡萄糖耐量试验（OGTT）在诊断高危个体糖调节受损中的应用。

方法

共有 713 例至少有两种 2 型糖尿病发病危险因素的患者纳入本研究。所有个体均检测空腹血糖和 HbA(1c)。空腹血糖浓度<7.0mmol/L 的患者行 OGTT。

结果

713 例患者中，234 例血糖正常，200 例空腹血糖受损，118 例糖耐量受损，161 例符合 2 型糖尿病诊断标准。共对 596 例患者（83.6%）进行了 OGTT。所有组的 HbA(1c)浓度均存在显著差异。行 HbA(1c)区分正常糖耐量和糖耐量受损的能力的受试者工作特征曲线分析。HbA(1c)值为 36mmol/mol（5.4%）时，诊断糖耐量受损的敏感度为 85%，特异度为 73%，阴性预测值为 97%。