Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Germany.
Ann Med. 2012 Mar;44(2):170-7. doi: 10.3109/07853890.2010.531759. Epub 2010 Nov 22.
The American Diabetes Association (ADA) has recently recommended HbA1c for diagnosing diabetes as an alternative to glucose-based criteria. We compared the new HbA1c-based criteria for diagnosis of diabetes and prediabetes with the glucose-based criteria.
In the population-based German KORA surveys (S4/F4) 1,764 non-diabetic participants aged 31-60 years and 896 participants aged 61-75 years underwent measurements of HbA1c, fasting plasma glucose (FPG), and 2-h glucose.
Only 20% of all subjects diagnosed with diabetes by glucose or HbA1c criteria had diabetes by both criteria; for prediabetes, the corresponding figure was 23%. Using HbA1c ≥ 6.5%, the prevalence of diabetes was strongly reduced compared to the glucose criteria (0.7% instead of 2.3% in the middle-aged, 2.9% instead of 7.9% in the older subjects). Only 32.0% (middle-aged) and 43.2% (older group) of isolated impaired glucose tolerance (i-IGT) cases were detected by the HbA1c criterion (5.7% ≤ HbA1c < 6.5%).
By glucose and the new HbA1c diabetes criteria, different subjects are diagnosed with type 2 diabetes in middle-aged as well as older subjects. The new HbA1c criterion lacks sensitivity for impaired glucose tolerance.
美国糖尿病协会（ADA）最近推荐将糖化血红蛋白（HbA1c）用于诊断糖尿病，作为基于血糖的标准的替代方法。我们比较了新的基于 HbA1c 的糖尿病和糖尿病前期诊断标准与基于血糖的标准。
在基于人群的德国 KORA 研究（S4/F4）中，共有 1764 名年龄在 31-60 岁的非糖尿病参与者和 896 名年龄在 61-75 岁的参与者接受了 HbA1c、空腹血浆葡萄糖（FPG）和 2 小时血糖检测。
仅 20%的通过血糖或 HbA1c 标准诊断为糖尿病的受试者同时符合两种标准；对于糖尿病前期，这一比例为 23%。与血糖标准相比，使用 HbA1c≥6.5%时，糖尿病的患病率明显降低（中年人群中为 0.7%，而不是 2.3%；老年人群中为 2.9%，而不是 7.9%）。仅 32.0%（中年组）和 43.2%（老年组）的孤立性糖耐量受损（i-IGT）病例被 HbA1c 标准检出（5.7%≤HbA1c<6.5%）。
通过血糖和新的 HbA1c 糖尿病标准，在中年和老年人群中诊断出不同的 2 型糖尿病患者。新的 HbA1c 标准对葡萄糖耐量受损的敏感性不足。
