Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
J Diabetes Res. 2018 May 22;2018:7932528. doi: 10.1155/2018/7932528. eCollection 2018.
In previous epidemiological screening in China, glycated albumin (GA) was mostly detected during the fasting state. This strict restriction causes some problems with diabetes screening. It is unclear if GA could help improve the efficiency of screening for diabetes for subjects who are not in the fasting state. The present study analyzed the differences between fasting and postload (30, 60, 120, and 180 min) GA levels. A total of 691 participants were enrolled in the present study. The Bland-Altman difference plots revealed that 95.4, 94.8, 93.6, and 93.9% of data points were within the limits of agreement for each time point. The receiver operating characteristic curve showed that the areas under the curve (AUC) for baseline GA and postload GA for every time point were 0.822 (95% CI 0.791-0.849), 0.821 (95% CI 0.790-0.848), 0.833 (95% CI 0.803-0.860), 0.840 (95% CI 0.811-0.867), and 0.840 (95% CI 0.810-0.867), with sensitivities of 67.5, 68.1, 69.3, 71.6, and 69.3%, respectively. There was no difference between the baseline and postload GA levels in either AUC or sensitivity (all > 0.05). In conclusion, postload serum GA levels were in good agreement with those at baseline, and thus, it may be reasonable to employ nonfasting measurements of GA levels for diabetes screening.
在中国之前的流行病学筛查中,糖化白蛋白 (GA) 大多在空腹状态下检测。这种严格的限制给糖尿病筛查带来了一些问题。目前尚不清楚 GA 是否有助于提高非空腹状态下受试者的糖尿病筛查效率。本研究分析了空腹和餐后(30、60、120 和 180 分钟)GA 水平之间的差异。本研究共纳入 691 名参与者。Bland-Altman 差值图显示,每个时间点的 95.4%、94.8%、93.6%和 93.9%的数据点均在一致性界限内。受试者工作特征曲线显示,各时间点的基线 GA 和餐后 GA 的曲线下面积(AUC)分别为 0.822(95%CI 0.791-0.849)、0.821(95%CI 0.790-0.848)、0.833(95%CI 0.803-0.860)、0.840(95%CI 0.811-0.867)和 0.840(95%CI 0.810-0.867),灵敏度分别为 67.5%、68.1%、69.3%、71.6%和 69.3%。AUC 或灵敏度方面,基线和餐后 GA 水平之间无差异(均>0.05)。结论:餐后血清 GA 水平与基线时一致,因此,采用非空腹 GA 水平进行糖尿病筛查可能是合理的。