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糖化血红蛋白在巴西半城市人口糖尿病诊断中的应用。

Glycated Hemoglobin in the Diagnosis of Diabetes Mellitus in a Semi-Urban Brazilian Population.

机构信息

Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo (UiO), Oslo 0318, Norway.

Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza-Ceará 60020-181, Brazil.

出版信息

Int J Environ Res Public Health. 2019 Sep 26;16(19):3598. doi: 10.3390/ijerph16193598.

Abstract

The study evaluated glycated hemoglobin (HbA1c) as a diagnostic tool for diabetes and pre-diabetes in the Brazilian population. Further, the homeostasis model assessment of insulin resistance (HOMA-IR) was also examined against HbA1c values to identify the most suitable cut-off points for HOMA-IR to predict the risk of diabetes. A cross-sectional study was conducted among 714 randomly selected subjects. HbA1c, fasting, and 2 h plasma glucose values were measured. Insulin resistance estimates were calculated with HOMA-IR. The receiver operating characteristic curve assessed HbA1c performance. The adjusted prevalence rate of diabetes mellitus was 14.7%, and pre-diabetes 14.2%. The optimal HbA1c cut-off value was ≥6.8% for the diagnosis of diabetes, and ≥6.0% for pre-diabetes. The area under the curve using HbA1c was 0.85 (95% CI: 0.80-0.90) for detecting diabetes and 0.61 (95% CI: 0.55-0.67) for pre-diabetes. The optimal HOMA-IR cut-off value was 2.06 for HbA1c at 6.8%. The HbA1c cut-off value of ≥6.8% may be suitable for diagnosing diabetes in the Brazilian population. Our results do not support the use of HbA1c to diagnose pre-diabetes. A HOMA-IR cut-off point of 2.06 was a sensitive marker to assess the risk of diabetes.

摘要

本研究评估了糖化血红蛋白(HbA1c)在巴西人群中作为糖尿病和糖尿病前期的诊断工具。此外,还针对 HbA1c 值检查了胰岛素抵抗的稳态模型评估(HOMA-IR),以确定最适合的 HOMA-IR 截断值来预测糖尿病风险。这是一项在 714 名随机选择的受试者中进行的横断面研究。测量了 HbA1c、空腹和 2 小时血浆葡萄糖值。使用 HOMA-IR 计算胰岛素抵抗估计值。接受者操作特征曲线评估了 HbA1c 的性能。调整后的糖尿病患病率为 14.7%,糖尿病前期为 14.2%。诊断糖尿病的最佳 HbA1c 截断值为≥6.8%,诊断糖尿病前期的最佳 HbA1c 截断值为≥6.0%。使用 HbA1c 时,曲线下面积(AUC)为 0.85(95%置信区间:0.80-0.90),用于检测糖尿病,AUC 为 0.61(95%置信区间:0.55-0.67),用于检测糖尿病前期。对于 HbA1c 为 6.8%时,最佳 HOMA-IR 截断值为 2.06。HbA1c 截断值≥6.8%可能适合诊断巴西人群中的糖尿病。我们的结果不支持使用 HbA1c 来诊断糖尿病前期。HOMA-IR 截断值 2.06 是评估糖尿病风险的敏感标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5abc/6801550/46652f86eef3/ijerph-16-03598-g001.jpg

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