Adamu A N
Departmentof Medicine, University of Ilorin, Nigeria.
Afr Health Sci. 2011 Sep;11(3):421-6.
International expert committee on the use of HbA1c to diagnose diabetes mellitus in 2009 and World Health Organization (WHO) in 2011 has advocated the use of HbA1c to diagnose diabetes mellitus.
To determine and compare the relationship between the new cut off value of HbA1c with established criteria.
Thirty-one hypertensive subjects attending Lagos University Teaching Hospital were recruited for HbA1c and standard oral glucose tolerance test. Fasting plasma glucose (FPG) and two-hour plasma glucose (2hrpp) value of e"126 mg/ dl and ≥200 mg/dl were used as standard respectively for diagnosis of diabetes. The HbA1c of e"6.5% was used to diagnose diabetes. The performance and correlation of HbA1c with FPG and 2hrpp were calculated and results were compared.
Mean age of the subjects was 53.97 ± 6.27 years. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), efficiency and correlation of FPG is 50%, 68%, 27%, 85%, 64% and 0.5 respectively while the sensitivity, specificity, PPV, NPV, efficiency and correlation of 2hrpp is 73.91%, 62.5%,85%, 41.66%, 70.97% and 0.73% respectively. There was a significant difference between FPG and 2hrpp in terms of sensitivity, PPV and NPV.
The results of HbA1c with 2hrpp has better correlation, sensitivity, and PPV compared to HbA1c with FPG.
2009年国际HbA1c用于诊断糖尿病专家委员会以及2011年世界卫生组织（WHO）都提倡使用HbA1c诊断糖尿病。
确定并比较HbA1c新的临界值与既定标准之间的关系。
招募31名前往拉各斯大学教学医院就诊的高血压患者，进行HbA1c检测和标准口服葡萄糖耐量试验。分别将空腹血糖（FPG）≥126mg/dl和两小时血糖（2hrpp）≥200mg/dl作为诊断糖尿病的标准。采用HbA1c≥6.5%诊断糖尿病。计算HbA1c与FPG和2hrpp的性能及相关性，并比较结果。
研究对象的平均年龄为53.97±6.27岁。FPG的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、效率及相关性分别为50%、68%、27%、85%、64%和0.5，而2hrpp的敏感性、特异性、PPV、NPV、效率及相关性分别为73.91%、62.5%、85%、41.66%、70.97%和0.73%。FPG和2hrpp在敏感性、PPV和NPV方面存在显著差异。
与HbA1c和FPG相比，HbA1c与2hrpp的结果具有更好的相关性、敏感性和PPV。
