南非一个城市中心结核病患者中的糖尿病及糖耐量异常情况。

Diabetes and abnormal glucose tolerance in subjects with tuberculosis in a South African urban center.

作者信息

Mcebula V, Crowther N J, Nagel S E, George J A

机构信息

Department of Chemical Pathology, National Health Laboratory Services, University of the Witwatersrand, Johannesburg, South Africa.

Department of Chemical Pathology, National Health Laboratory Services, University of the Witwatersrand, Johannesburg, South Africa, Department of Chemical Pathology, National Health Laboratory Services, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Int J Tuberc Lung Dis. 2017 Feb 1;21(2):208-213. doi: 10.5588/ijtld.15.0831.

DOI:10.5588/ijtld.15.0831

PMID:28234086

Abstract

SETTING

Primary health care clinics.

OBJECTIVES

To determine the prevalence of diabetes mellitus (DM) in tuberculosis (TB) patients using glycated haemoglobin (HbA1c), and to compare the performance of laboratory and point-of-care (POC) HbA1c measurement.

METHODS

This was a cross-sectional study of 325 patients. Screening was at POC using laboratory HbA1c methods; DM was confirmed by the oral glucose tolerance test (OGTT). Multivariate regression analysis was performed to determine predictors of HbA1c.

RESULTS

Mean laboratory-derived HbA1c was significantly higher than mean POC HbA1c (P = 0.007). Of 83 subjects who underwent OGTT, 2 (2.4%) were diagnosed with DM, 3 (3.60%) with impaired fasting glucose and 15 (18.1%) with impaired glucose tolerance. Twelve (14.5%) had an HbA1c of 6.50% using POC HbA1c and 21 (25.3%) using laboratory HbA1c. In multivariate regression analysis, age and weight were positively associated with both laboratory and POC HBA1c, while duration of anti-tuberculosis treatment was negatively associated with both.

CONCLUSION

Glucose and HbA1c levels fell with increased duration of anti-tuberculosis treatment, suggesting that the optimal time for DM screening in this population was at least 5 months after TB was first diagnosed. Our data suggest that the use of HbA1c is inappropriate for testing glycaemia in patients with TB.

摘要

背景

基层医疗诊所。

目的

使用糖化血红蛋白（HbA1c）测定结核病（TB）患者中糖尿病（DM）的患病率，并比较实验室检测和即时检测（POC）HbA1c的性能。

方法

这是一项对325名患者的横断面研究。采用实验室HbA1c方法在即时检测点进行筛查；通过口服葡萄糖耐量试验（OGTT）确诊DM。进行多变量回归分析以确定HbA1c的预测因素。

结果

实验室检测得出的平均HbA1c显著高于即时检测的平均HbA1c（P = 0.007）。在83名接受OGTT的受试者中，2人（2.4%）被诊断为DM，3人（3.60%）空腹血糖受损，15人（18.1%）糖耐量受损。使用即时检测HbA1c时，12人（14.5%）的HbA1c≥6.50%，使用实验室HbA1c时为21人（25.3%）。在多变量回归分析中，年龄和体重与实验室检测和即时检测的HbA1c均呈正相关，而抗结核治疗时间与两者均呈负相关。