Suppr超能文献

糖化血红蛋白(HbA1c)是否可用于筛查 2 型糖尿病及糖调节受损人群?

Should glycated haemoglobin (HbA1c) be used to detect people with type 2 diabetes mellitus and impaired glucose regulation?

机构信息

Division of Diabetes and Endocrinology, Department of Cardiovascular Sciences, Level 0, Victoria Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK.

出版信息

Postgrad Med J. 2010 Nov;86(1021):656-62. doi: 10.1136/pgmj.2009.091215. Epub 2010 Oct 18.

Abstract

There is a need to simplify screening tests for type 2 diabetes mellitus (T2DM) so patients can be identified earlier and more efficiently. Glycated haemoglobin (HbA1c) has been recommended by some international organisations as a diagnostic tool for detecting T2DM and impaired glucose regulation (IGR, also termed prediabetes and includes impaired fasting glucose and/or impaired glucose tolerance). The HbA1c cut-point of ≥6.5% (48 mmol/mol) has been selected as diagnostic for T2DM, while the cut-points for IGR are debated by the different international organisations: an International Expert Committee has suggested using HbA1c 6.0-6.4% (42-46 mmol/mol); however, the American Diabetes Association has recommended using HbA1c 5.7-6.4% (39-46 mmol/mol). Some countries will adopt a new method of reporting HbA1c values in millimoles per mole (mmol/mol). Use of HbA1c has some logistical advantages over using an oral glucose tolerance test (OGTT). As patients do not need to fast, appointments do not need to be limited to the morning. The HbA1c result reflects longer term glycaemia and is less affected by recent physical/emotional stress. However, there is some debate as to whether HbA1c should replace fasting plasma glucose or the OGTT. As the two tests detect different people, some individuals with diabetes detected on OGTT will no longer be classified as having T2DM using HbA1c ≥6.5% criteria. Furthermore, some medical conditions can result in HbA1c assay measurements not reflecting glycaemic control over the last 2-3 months; these include haematological disorders, renal failure, and chronic excess alcohol consumption.

摘要

需要简化 2 型糖尿病(T2DM)的筛查测试,以便更早、更有效地发现患者。一些国际组织推荐糖化血红蛋白(HbA1c)作为诊断工具,用于检测 T2DM 和葡萄糖调节受损(IGR,也称为糖尿病前期,包括空腹血糖受损和/或葡萄糖耐量受损)。HbA1c 切点≥6.5%(48mmol/mol)被选为 T2DM 的诊断标准,而不同国际组织对 IGR 的切点存在争议:一个国际专家委员会建议使用 HbA1c 6.0-6.4%(42-46mmol/mol);然而,美国糖尿病协会建议使用 HbA1c 5.7-6.4%(39-46mmol/mol)。一些国家将采用一种新的报告 HbA1c 值的方法,即毫摩尔每摩尔(mmol/mol)。与使用口服葡萄糖耐量试验(OGTT)相比,HbA1c 具有一些后勤优势。由于患者无需禁食,因此预约时间无需限于上午。HbA1c 结果反映了更长期的血糖水平,并且受近期身体/情绪压力的影响较小。然而,关于 HbA1c 是否应该替代空腹血糖或 OGTT 存在一些争议。由于这两种测试检测到的是不同的人群,因此使用 OGTT 检测到的一些糖尿病患者将不再被 HbA1c≥6.5%标准归类为患有 T2DM。此外,一些医疗状况可能导致 HbA1c 检测结果不能反映过去 2-3 个月的血糖控制情况;这些包括血液疾病、肾衰竭和慢性过量饮酒。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验