Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Acta Diabetol. 2012 Dec;49 Suppl 1:S73-9. doi: 10.1007/s00592-011-0260-6. Epub 2011 Feb 22.
The aim of this study was to estimate the incidence of type 2 diabetes using newly proposed hemoglobin A(1C) (HbA(1c)) and current oral glucose tolerance test (OGTT) definition in an Iranian non-diabetic population. A total of 923 non-diabetic first-degree relatives (FDRs) of patients with type 2 diabetes 30-70 years old in 2003-2005 were followed through 2009 for the occurrence of type 2 diabetes. At baseline and through follow-ups, participants underwent a standard 75 g 2-h OGTT and HbA(1c) measurements. Prediction of progression to type 2 diabetes by OGTT-defined or HbA(1c)-defined diabetes was assessed with area under the receiver operating characteristic (ROC) curves based upon measurement of fasting plasma glucose, 2-h post-load glucose values, and HbA(1c). The prevalence of type 2 diabetes was 9.2% (95% CI: 8.2, 10.2) by OGTT-defined diabetes and 7.9% (95% CI: 6.9, 9.0) by HbA(1c) ≥ 6.5. The incidence of type 2 diabetes was 2.0% (95% CI: 1.6, 2.4) (1.8% men and 2.1% women) per year by the current OGTT definition, whereas the incidence rates were 1.7% (95% CI: 1.3, 2.0) (1.6% men and 1.7% women) per year by HbA(1c) ≥ 6.5%. Of those diagnosed with type 2 diabetes by OGTT, 69.6% had HbA(1c) <6.5% and therefore would not have been classified as having type 2 diabetes. The incidence and prevalence of diabetes using newly proposed HbA(1c) threshold in this FDRs of patients with type 2 diabetes were slightly lower than using current OGTT definition.
本研究旨在估算伊朗非糖尿病人群中使用新提出的糖化血红蛋白（HbA(1c)）和当前口服葡萄糖耐量试验（OGTT）定义的 2 型糖尿病发病率。2003-2005 年，对 923 名年龄在 30-70 岁之间的 2 型糖尿病患者的一级亲属（FDRs）进行了随访，以观察 2 型糖尿病的发生情况。在基线和随访期间，参与者接受了标准的 75g 2 小时 OGTT 和 HbA(1c)测量。通过基于空腹血糖、2 小时负荷后血糖值和 HbA(1c)测量的接受者操作特征（ROC）曲线下面积，评估 OGTT 定义或 HbA(1c)定义的糖尿病对进展为 2 型糖尿病的预测。通过 OGTT 定义的糖尿病，2 型糖尿病的患病率为 9.2%（95%CI：8.2，10.2），通过 HbA(1c)≥6.5 定义为 7.9%（95%CI：6.9，9.0）。根据当前 OGTT 定义，2 型糖尿病的年发病率为 2.0%（95%CI：1.6，2.4）（男性 1.8%，女性 2.1%），而根据 HbA(1c)≥6.5，年发病率为 1.7%（95%CI：1.3，2.0）（男性 1.6%，女性 1.7%）。在通过 OGTT 诊断为 2 型糖尿病的患者中，有 69.6%的患者 HbA(1c)＜6.5%，因此不会被归类为 2 型糖尿病。在这些 2 型糖尿病患者的 FDRs 中，使用新提出的 HbA(1c)阈值诊断的糖尿病的发病率和患病率略低于当前 OGTT 定义。
