Institut de Recherches Cliniques de Montréal, Montréal, Québec, H2W 1R7, Canada; Department of Nutrition, Université de Montréal, Montréal, Québec, Canada.
Institut de Recherches Cliniques de Montréal, Montréal, Québec, H2W 1R7, Canada; Department of Nutrition, Université de Montréal, Montréal, Québec, Canada; Cystic Fibrosis Clinic, Centre hospitalier de l'Université de Montréal (CHUM)-Hôtel-Dieu, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada.
J Cyst Fibros. 2016 Mar;15(2):258-60. doi: 10.1016/j.jcf.2016.02.005. Epub 2016 Feb 19.
With improved life expectancy of cystic fibrosis (CF) patients, CF-related diabetes (CFRD) has become a major complication. The oral glucose tolerance test (OGTT) is the standard test to detect it. However, the use of OGTT is controversial, in addition to being a burden for patients and the treatment team. Research to find alternative ways of testing is ongoing. While some propose that glycated hemoglobin (HbA1c) may be an effective alternative, our past results suggest otherwise. A new analysis involving the OGTT and HbA1c values of 207 patients, between 2004 and 2015, proposes that the threshold of a lower value of HbA1c of ≥5.8%(39.9 mmol/mol) gives a sensitivity of 68.2% and a specificity of 60.5%. With such sensitivity to identify patients in need of an OGTT, 31.8% of CFRD diagnosis would be missed if the suggested HbA1c value of ≥5.8% was used as a screening tool to identify patients in need of OGTTs. Considering our results, we believe the HbA1c does not possess the characteristics of a suitable screening test for CFRD.
随着囊性纤维化 (CF) 患者预期寿命的提高,CF 相关糖尿病 (CFRD) 已成为一种主要并发症。口服葡萄糖耐量试验 (OGTT) 是检测它的标准试验。然而,OGTT 的使用存在争议,除了给患者和治疗团队带来负担之外。寻找替代测试方法的研究仍在进行中。虽然有人提出糖化血红蛋白 (HbA1c) 可能是一种有效的替代方法,但我们过去的结果表明并非如此。一项新的分析涉及 207 名患者在 2004 年至 2015 年间的 OGTT 和 HbA1c 值,提出 HbA1c 值<5.8%(39.9 mmol/mol)的较低值的阈值具有 68.2%的敏感性和 60.5%的特异性。如果将建议的 HbA1c 值≥5.8%用作 OGTT 需求患者的筛查工具,那么敏感性足以识别需要 OGTT 的患者,将漏诊 31.8%的 CFRD 诊断。考虑到我们的结果,我们认为 HbA1c 不具备作为 CFRD 合适筛查试验的特征。