Huang Shu'e, Zhang Jian, Meng Liping, Song Pengkun, Man Qingqing, Li Lixiang, Wang Chunrong, Fu Ping, Jia Shanshan
Wei Sheng Yan Jiu. 2014 May;43(3):439-43.
To compare the performance of glycated hemoglobin (HbA1c) and oral glucose tolerance test (OGTT) in diagnosing diabetes and pre-diabetes in the general population.
A total of 1416 subjects from Nanchang, Jiangxi Province and Wuhan, Hubei Province who have participated the 2010 Chinese Nutrition and Health Survey were studied and their HbA1c were measured. The glycemic levels and distribution of the subjects diagnosed with diabetes and pre-diabetes by OGTT and HbA1c were compared. Receiver operating characteristic curves were constructed to determine the sensitivity and specificity of HbA1c in detecting diabetes as defined by OGTT.
According to the 1999 WHO criteria, 86 subjects were diagnosed with diabetes and 262 were with pre-diabetes. Comparing with OGTT, the sensitivity and specificity of HbA1c > or = 6.5% was 41.9% and 98.9%. Subjects with diabetes diagnosed by HbA1c and OGTT were not consistent, and they have different HbA1c level. The HbA1c level of 5.7% - 6.4% was associated with a sensitivity of 78.6% and a specificity of 55.1% in detecting impaired glucose regulation (IGR). Cases with pre-diabetes identified by HbA1c 5.7% - 6.4% were different from those with IGR. They had lower fasting glucose and 2-hour plasma glucose after glucose load than those with IGR.
Among this studied population, HbA1c > or = 6.5% showed high specificity but low sensitivity for detecting glucose-defined diabetes. The performance of HbA1c of 5.7% -6.4% in screening pre-diabetes is poor.
比较糖化血红蛋白（HbA1c）和口服葡萄糖耐量试验（OGTT）在普通人群中诊断糖尿病及糖尿病前期的效能。
对来自江西省南昌市和湖北省武汉市的1416名参与2010年中国营养与健康调查的受试者进行研究，并检测其HbA1c水平。比较通过OGTT和HbA1c诊断为糖尿病及糖尿病前期的受试者的血糖水平及分布情况。绘制受试者工作特征曲线，以确定HbA1c检测OGTT定义的糖尿病的敏感性和特异性。
根据1999年世界卫生组织标准，86名受试者被诊断为糖尿病，262名受试者为糖尿病前期。与OGTT相比，HbA1c≥6.5%的敏感性和特异性分别为41.9%和98.9%。通过HbA1c和OGTT诊断为糖尿病的受试者不一致，且他们的HbA1c水平不同。HbA1c水平在5.7% - 6.4%时，检测糖调节受损（IGR）的敏感性为78.6%，特异性为55.1%。HbA1c为5.7% - 6.4%诊断为糖尿病前期的病例与IGR病例不同。他们的空腹血糖和葡萄糖负荷后2小时血浆葡萄糖水平低于IGR患者。
在本研究人群中，HbA1c≥6.5%在检测血糖定义的糖尿病时显示出高特异性但低敏感性。HbA1c在5.7% - 6.4%时筛查糖尿病前期的效能较差。
