[血清晚期糖基化终末产物-肽在社区高危糖尿病患者人群糖尿病筛查中的价值]

[Value of serum advanced glycation end products-peptide in the screening of diabetes mellitus in a community-based population of high-risk diabetics].

作者信息

Xie Zuo-ling, Zhang Lin, Wang Yan-ping, He Jia-jia, Zhou Yi, Lei Cheng-hao, Qiu Shan-hu, Sun Zi-lin

机构信息

Department of Endocrinology, Zhongda Hospital, Southeast University, Nanjing 210009, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Oct 30;92(40):2843-6.

PMID:23290214

Abstract

OBJECTIVE

To explore the value of serum advanced glycation end products-peptide (AGE-P) in the screening of diabetes mellitus in a community-based population of high-risk diabetics.

METHODS

A total number of 857 adult high-risk diabetics from a community-based population underwent 75 g oral glucose tolerance test (OGTT). Blood samples were drawn to measure the levels of fasting blood glucose (FBG), postprandial blood glucose (2 hPG) and glycosylated hemoglobin A1c (HbA1c). And blood samples were also collected to determine the serum level of AGE-P with the technique of flow injection analysis. Receiver operating characteristic (ROC) curve was plotted to assess the screening value of serum AGE-P in diabetes mellitus. Pearson correlation analysis was conducted to evaluate the association between serum AGE-P and FBG, 2 hPG, HbA1c, body mass index (BMI), waist-to-hip ratio (WHR) and age.

RESULTS

Among them, 218 adults were diagnosed with diabetes based on the 2010 American Diabetes Association (ADA) criteria. According to the ROC curve, the optimal cut-point of serum AGE-P for diagnosing diabetes was 10.22 mg/L (a peak height of 25.39 mm) with sensitivity of 84.1%, specificity of 88.3% and positive predictive value of 71%. The area under curve (AUC) of serum AGE-P, FBG, 2 hPG and HbA1c for diagnosing diabetes was 0.924, 0.905, 0.951 and 0.874 respectively. When comparing AUC between serum AGE-P and HbA1c, FBG and 2 hPG, statistical significance was only found in the comparisons between serum AGE-P and HbA1c (P<0.025). Pearson correlation analysis showed that serum AGE-P was highly positively correlated with HbA1c, significantly positively correlated with FBG and 2 hPG and slightly positively correlated with WHR and age (all P<0.05). But there was no correlation with BMI.

CONCLUSIONS

Serum AGE-P may be used for the screening of diabetes in the community-based population of high-risk diabetics. And it is even superior to HbA1c.

摘要

目的

探讨血清晚期糖基化终末产物-肽（AGE-P）在社区高危糖尿病患者人群中筛查糖尿病的价值。

方法

对来自社区人群的857名成年高危糖尿病患者进行75g口服葡萄糖耐量试验（OGTT）。采集血样以测定空腹血糖（FBG）、餐后血糖（2hPG）和糖化血红蛋白A1c（HbA1c）水平。同时采集血样，采用流动注射分析法测定血清AGE-P水平。绘制受试者工作特征（ROC）曲线，评估血清AGE-P在糖尿病筛查中的价值。进行Pearson相关性分析，以评估血清AGE-P与FBG、2hPG、HbA1c、体重指数（BMI）、腰臀比（WHR）和年龄之间的关联。

结果

其中，根据2010年美国糖尿病协会（ADA）标准，218名成年人被诊断为糖尿病。根据ROC曲线，血清AGE-P诊断糖尿病的最佳切点为10.22mg/L（峰高25.39mm），灵敏度为84.1%，特异度为88.3%，阳性预测值为71%。血清AGE-P、FBG、2hPG和HbA1c诊断糖尿病的曲线下面积（AUC）分别为0.924、0.905、0.951和0.874。比较血清AGE-P与HbA1c、FBG和2hPG的AUC时，仅在血清AGE-P与HbA1c的比较中发现统计学意义（P<0.025）。Pearson相关性分析显示，血清AGE-P与HbA1c高度正相关，与FBG和2hPG显著正相关，与WHR和年龄轻度正相关（均P<0.05）。但与BMI无相关性。