Olson Byron P, Matter Nathaniel I, Ediger Marwood N, Hull Edward L, Maynard John D
VeraLight Inc., Albuquerque, New Mexico, USA.
J Diabetes Sci Technol. 2013 Jul 1;7(4):990-1000. doi: 10.1177/193229681300700422.
We compare performance of noninvasive skin fluorescence spectroscopy (SFS), fasting plasma glucose (FPG), and hemoglobin A1c (A1C) for detection of abnormal glucose tolerance (AGT).
The NSEEDS trial evaluated SFS, FPG, and A1C in an at-risk population of 479 previously undiagnosed subjects from nine US centers, each of whom received a 75 g, 2 h oral glucose tolerance test (OGTT). Skin fluorescence spectra were collected and analyzed with SCOUT DS® devices. Disease truth was AGT, defined as OGTT ≥140 mg/dl. Abnormal glucose tolerance sensitivity, false positive rate (FPR), and receiver operating characteristic (ROC) curves were computed for each measurement technique. Skin fluorescence spectroscopy reproducibility was also assessed.
The AGT sensitivity of SFS was 68.2%, higher than that of FPG (thresholds of 100 and 110 mg/dl) and A1C (thresholds of 5.7% and 6.0%). The FPR of SFS was 37.7%, comparable to A1C at the 5.7% threshold (30.7%). Partial ROC areas of SFS, FPG, and A1C were similar for FPRs of 20-50% (average sensitivities of 64.0%, 59.0%, and 68.6%, respectively). The interday coefficient of variation for SFS was 7.6%.
Skin fluorescence spectroscopy has similar screening performance to FPG and A1C and is a viable approach for detection of AGT.
我们比较无创皮肤荧光光谱法（SFS）、空腹血糖（FPG）和糖化血红蛋白（A1C）检测糖耐量异常（AGT）的性能。
NSEEDS试验在来自美国九个中心的479名既往未确诊的高危人群中评估了SFS、FPG和A1C，每位受试者均接受了75克、2小时口服葡萄糖耐量试验（OGTT）。使用SCOUT DS®设备收集并分析皮肤荧光光谱。疾病真相为AGT，定义为OGTT≥140毫克/分升。计算每种测量技术下的糖耐量异常敏感性、假阳性率（FPR）和受试者工作特征（ROC）曲线。还评估了皮肤荧光光谱的可重复性。
SFS的AGT敏感性为68.2%，高于FPG（阈值为100和110毫克/分升）和A1C（阈值为5.7%和6.0%）。SFS的FPR为37.7%，与A1C在5.7%阈值时的FPR（30.7%）相当。对于20 - 50%的FPR，SFS、FPG和A1C的部分ROC面积相似（平均敏感性分别为64.0%、59.0%和68.6%）。SFS的日间变异系数为7.6%。
皮肤荧光光谱法与FPG和A1C具有相似的筛查性能，是检测AGT的一种可行方法。
