Franco Luciana Ferreira, Mafra Ana Carolina Cintra Nunes, Bracco Mario Maia, Franco Laercio Joel, Naves Larissa Kozloff, Ribeiro Glória Maria Ferreira, Mangueira Cristóvão Luis Pitangueira
Hospital Israelita Albert Einstein - São Paulo (SP), Brasil.
Hospital Municipal Dr. Moysés Deutsch - São Paulo (SP), Brasil.
Rev Bras Epidemiol. 2019 Nov 25;22:e190058. doi: 10.1590/1980-549720190058. eCollection 2019.
Fasting glucose is a test used for monitoring diabetes mellitus, as well as its screening and diagnosis. The objective of this study was to evaluate fasting glucose results and their correlation with glycated hemoglobin and lipids.
Cross-sectional study, involving 77,581 patients, attended in 2014.
The majority of the patients are women (65%). The age of the patients ranged from 18 to 115 years (mean of 53 ± 15.5). The agreement between fasting glucose and glycated hemoglobin was moderate (kappa = 0.416); however, it was substantial for the levels used for the diagnosis of diabetes (kappa = 0.689) and poor for pre-diabetes (kappa = 0.188). Fasting glucose ≥ 100 mg/dL was observed in 41.1% of the patients and 61.5% present glycated hemoglobin ≥ 5.7%. Lipid abnormalities are likeliest in patients with elevated fasting glucose. From those 14,241 individuals that had fasting glucose ≥ 126 mg/dL, the microalbuminuria test was performed in only 883 (6.2%) patients, with abnormal results in 201 (22.8%).
The high frequency of fasting glucose with abnormal results may reflect the high proportion of exams performed by individuals with diagnosis of diabetes, to evaluate their glycemic control. The low frequency of requests for microalbuminuria tests in those with probable diagnosis of diabetes reflects the little attention paid for the screening of chronic complications of diabetes. It calls attention the high frequency of dyslipidemia in those individuals, highlighting the fact that this is a population with high cardiovascular risk.
空腹血糖是一种用于监测糖尿病及其筛查和诊断的检测方法。本研究的目的是评估空腹血糖结果及其与糖化血红蛋白和血脂的相关性。
横断面研究，纳入了2014年就诊的77581名患者。
大多数患者为女性（65%）。患者年龄在18至115岁之间（平均53±15.5岁）。空腹血糖与糖化血红蛋白之间的一致性为中等（kappa = 0.416）；然而，对于用于糖尿病诊断的水平一致性较高（kappa = 0.689），而对于糖尿病前期一致性较差（kappa = 0.188）。41.1%的患者空腹血糖≥100mg/dL，61.5%的患者糖化血红蛋白≥5.7%。空腹血糖升高的患者最容易出现血脂异常。在14241名空腹血糖≥126mg/dL的个体中，仅883名（6.2%）患者进行了微量白蛋白尿检测，其中201名（22.8%）结果异常。
空腹血糖结果异常的高频率可能反映了被诊断为糖尿病的个体进行检测以评估其血糖控制的高比例。在可能诊断为糖尿病的患者中微量白蛋白尿检测请求的低频率反映了对糖尿病慢性并发症筛查的关注不足。这引起了对这些个体中血脂异常高频率的关注，突出了这是一个心血管风险高的人群这一事实。
