Zhang Ting, He He, Yang Hui-Lan, Huang Heng-Jian, Zhang Ming-Feng, An Zhen-Mei, Li Shuang-Qing
Sichuan Da Xue Xue Bao Yi Xue Ban. 2014 Mar;45(2):274-7, 298.
To investigate the cut-off point of glycated albumin (GA) in the detection of diabetes mellitus (DM) and impaired glucose regulation (IGR).
This study was conducted in 20-84 years-old adults who had risk factors of diabetes but no previously diagnosed diabetes. There were finally 392 individuals included and received the measurement of GA and HbA1c. Receiver operating characteristic curve (ROC) was plotted to determine the performance of GA.
(1) Based on the diabetes diagnosis criteria of WHO (1999), the subjects were divided into DM group (n = 131), IGR group (n = 126), and normal glucose tolerance (NGT) group (n = 135). The GA level in the three groups tended to increase (P < 0.05). (2) Spearman correlation analysis demonstrated that GA was positively correlated with glycated haemoglobin A1c (HbA1c) (r = 0.942 1, P < 0.05), fasting plasma glucose (FPG) (r = 0.856 6, P < 0.05) and 2 h post-load plasma glucose (2-hPG) (r = 0.813 7, P < 0.05). (3) The mean levels of serum GA/HbA1c were 2.58 +/- 0.37, 2.44 +/- 0.37 and 2.17 +/- 0.25 for DM, IGR and NGT respectively. (4) The optimal cut-off points for detecting diabetes were 16.6% in GA [area under the carve (AUC) = 0.888], producing the sensitivity of 71.8% and the specificity of 87.4%.
GA as a single screening test shows adequate to detect newly diagnosed DM, and the optimal GA cut-off point was 16.6% in this study.
探讨糖化白蛋白(GA)在糖尿病(DM)及糖调节受损(IGR)检测中的切点。
本研究纳入年龄在20 - 84岁、有糖尿病危险因素但既往未诊断糖尿病的成年人。最终共纳入392例个体,进行GA和糖化血红蛋白(HbA1c)检测。绘制受试者工作特征曲线(ROC)以评估GA的性能。
(1)根据世界卫生组织(1999年)糖尿病诊断标准,将受试者分为DM组(n = 131)、IGR组(n = 126)和正常糖耐量(NGT)组(n = 13)。三组GA水平呈上升趋势(P < 0.05)。(2)Spearman相关性分析显示,GA与糖化血红蛋白A1c(HbA1c)(r = 0.942 1,P < 0.05)、空腹血糖(FPG)(r = 0.856 6,P < 0.05)及餐后2小时血糖(2-hPG)(r = 0.813 7,P < 0.05)呈正相关。(3)DM组、IGR组和NGT组血清GA/HbA1c的平均水平分别为2.58±0.37、2.44±0.37和2.17±0.25。(4)GA检测糖尿病的最佳切点为16.6% [曲线下面积(AUC) = 0.888],灵敏度为71.8%,特异度为87.4%。
GA作为单一筛查试验对新诊断DM的检测具有足够的效能,本研究中GA的最佳切点为16.6%。