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血清1,5-脱水葡萄糖醇水平作为社区糖尿病高危人群糖尿病筛查工具的研究

Serum 1,5-anhydroglucitol level as a screening tool for diabetes mellitus in a community-based population at high risk of diabetes.

作者信息

Wang Yao, Yuan Yuexing, Zhang Yanli, Lei Chenghao, Zhou Yi, He Jiajia, Sun Zilin

机构信息

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

Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China.

出版信息

Acta Diabetol. 2017 May;54(5):425-431. doi: 10.1007/s00592-016-0944-z. Epub 2016 Nov 28.

Abstract

AIMS

Early diagnosis of diabetes yields significant clinical benefits; however, currently available diagnostic tools for community-based population are limited. This study aimed to assess the value of serum 1,5-anhydroglucitol (1,5-AG) for the diagnosis and screening of diabetes mellitus in a community-based population at high risk of diabetes.

METHODS

In this diagnostic test, 1170 participants underwent a 75-g oral glucose tolerance test. Venous blood samples were collected for fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and glycosylated hemoglobin A1c (HbA1c) measurements. Serum 1,5-AG levels were detected by the GlycoMark assay, and a receiver operating characteristic (ROC) curve was generated to assess their diagnostic value for diabetes.

RESULTS

A total of 298 adults were diagnosed with diabetes, indicating a prevalence of 25.47%. Partial Pearson correlation analysis adjusted for age and body mass index showed that serum 1,5-AG level was negatively correlated with FBG, PBG, and HbA1c (all P < 0.01). Areas under the curves (AUCs) for serum 1,5-AG, FBG, PBG, and HbA1c in identifying diabetes were 0.920, 0.874, 0.933, and 0.887, respectively. According to the ROC curve, the optimal cutoff value of serum 1,5-AG for diagnosing diabetes was 11.18 μg/ml, which yielded a sensitivity of 92.6% and a specificity of 82.3%, respectively. Comparisons between 1,5-AG and HbA1c showed that both the AUC and sensitivity of 1,5-AG were higher than those of HbA1c (both P < 0.01).

CONCLUSIONS

Serum 1,5-AG is a simple and effective marker with high sensitivity and specificity for identifying diabetes in populations at high risk of diabetes.

摘要

目的

糖尿病的早期诊断具有显著的临床益处;然而,目前针对社区人群的可用诊断工具有限。本研究旨在评估血清1,5-脱水葡萄糖醇(1,5-AG)在糖尿病高危社区人群中对糖尿病诊断和筛查的价值。

方法

在这项诊断试验中,1170名参与者接受了75克口服葡萄糖耐量试验。采集静脉血样本用于测定空腹血糖(FBG)、餐后2小时血糖(PBG)和糖化血红蛋白A1c(HbA1c)。通过GlycoMark检测法检测血清1,5-AG水平,并绘制受试者工作特征(ROC)曲线以评估其对糖尿病的诊断价值。

结果

共有298名成年人被诊断为糖尿病,患病率为25.47%。经年龄和体重指数校正的偏Pearson相关分析显示,血清1,5-AG水平与FBG、PBG和HbA1c呈负相关(均P<0.01)。血清1,5-AG、FBG、PBG和HbA1c在识别糖尿病方面的曲线下面积(AUC)分别为0.920、0.874、0.933和0.887。根据ROC曲线,血清1,5-AG诊断糖尿病的最佳截断值为11.18μg/ml,其敏感性和特异性分别为92.6%和82.3%。1,5-AG与HbA1c的比较显示,1,5-AG的AUC和敏感性均高于HbA1c(均P<0.01)。

结论

血清1,5-AG是一种简单有效的标志物,对糖尿病高危人群中的糖尿病识别具有高敏感性和特异性。

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