糖化血红蛋白（HbA(1C)）用于检测中国 2 型糖尿病患者视网膜病变的切点。

The change points of HbA(1C) for detection of retinopathy in Chinese type 2 diabetic patients.

机构信息

Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China.

出版信息

Diabetes Res Clin Pract. 2011 Mar;91(3):401-5. doi: 10.1016/j.diabres.2010.11.029. Epub 2010 Dec 13.

DOI:10.1016/j.diabres.2010.11.029

PMID:21146885

Abstract

AIMS

To investigate the change points of HbA(1C) for detection of retinopathy in Chinese type 2 diabetic patients.

METHODS

This cross-sectional investigation included 992 diagnosed type 2 diabetic patients, who received non-mydriatic digital fundus photography examination. Joinpoint regression software was adopted to identify the change points of HbA(1C) in association with retinopathy prevalence.

RESULTS

The mean age of all patients was 59.1 ± 8.4 years and the duration of diabetes was 5.5 (95% CI: 5.2-5.9) years. The prevalence of retinopathy was 10.3% in total, and 4.1%, 7.4% and 19.6% in patients with different diabetes duration of ≤ 5 years, 5-10 years and >10 years, respectively. The change point of HbA(1C) was 6.5% (95%CI 5.8-7.5%), at which retinopathy prevalence began to rise sharply. Furthermore, in subjects with diabetes duration ≤ 5 years, 5-10 years and >10 years, the change points of HbA(1C) were 8.1% (95%CI 7.9-8.3%), 6.1% (95%CI 5.7-6.8%), 5.6% (95%CI 5.1-8.1%) for detection of retinopathy, respectively.

CONCLUSION

The steepest increase in retinopathy prevalence occurred when HbA(1C) reached 6.5%. However, the duration of diabetes should be taken into concern, when using the change points of HbA(1C) for detection of retinopathy in diabetic patients.

摘要

目的

探讨糖化血红蛋白（HbA1c）切点用于中国 2 型糖尿病患者视网膜病变筛查的变化情况。

方法

本横断面研究纳入了 992 例确诊的 2 型糖尿病患者，所有患者均接受免散瞳眼底数码照相检查。采用 Joinpoint 回归软件确定与视网膜病变患病率相关的 HbA1c 变化点。

结果

所有患者的平均年龄为 59.1±8.4 岁，糖尿病病程为 5.5（95%CI：5.2-5.9）年。总的视网膜病变患病率为 10.3%，病程≤5 年、5-10 年和>10 年的患者视网膜病变患病率分别为 4.1%、7.4%和 19.6%。HbA1c 的变化点为 6.5%（95%CI 5.8-7.5%），在此切点之后，视网膜病变的患病率开始急剧上升。此外，病程≤5 年、5-10 年和>10 年的患者中，HbA1c 用于检测视网膜病变的切点分别为 8.1%（95%CI 7.9-8.3%）、6.1%（95%CI 5.7-6.8%）和 5.6%（95%CI 5.1-8.1%）。