Division of Anaesthesiology and Perioperative Medicine, Sengkang General Hospital, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
Duke-NUS (National University of Singapore) Medical School, 8 College Rd, Singapore, 169857, Singapore.
Sci Rep. 2020 Nov 4;10(1):19067. doi: 10.1038/s41598-020-76105-2.
Type 2 Diabetes Mellitus (DM) is a chronic disease with high prevalence worldwide. Using glycated haemoglobin (HbA1c) as a surrogate for potential pre-DM and DM conditions, our primary objective was to determine the HbA1c epidemiology in non-cardiac elective surgical patients in Singapore. Our secondary aim was to identify risk factors associated with elevated HbA1c. We conducted a prospective, observational single-centre study in adult patients. HbA1c screening was performed. Patient demographics and comorbidities were recorded. Patients were divided into those with HbA1C ≤ 6.0% and HbA1C ≥ 6.1%. Regression analyses were performed to identify associated factors. Subgroup analysis was performed comparing patients with HbA1C ≥ 6.1% and HbA1C ≥ 8.0%. Of the 875 patients recruited, 182 (20.8%) had HbA1c ≥ 6.1%, of which 32 (3.7%) had HbA1c ≥ 8%. HbA1C ≥ 6.1% was associated with Indian ethnicity [1.07 (1.01-1.13), p = 0.023], BMI > 27.5 [1.07 (1.02-1.11), p = 0.002], higher preoperative random serum glucose [1.03 (1.02-1.04), p < 0.001], pre-existing diagnosis of DM [1.85 (1.75-1.96), p < 0.001] and prediabetes [1.44 (1.24-1.67), p < 0.001], and peripheral vascular disease [1.30 (1.10-1.54), p = 0.002]. HbA1c ≥ 8% had an additional association with age > 60 years [0.96 (0.93-0.99), p = 0.017]. The prevalence of elevated HbA1c is high among the surgical population. Targeted preoperative HbA1c screening for at-risk elective surgical patients reduces cost, allowing focused use of healthcare resources.
2 型糖尿病（DM）是一种全球高发的慢性病。本研究以糖化血红蛋白（HbA1c）作为潜在糖尿病前期和糖尿病的替代指标，旨在明确新加坡非心脏择期手术患者的 HbA1c 流行病学特征，并确定与 HbA1c 升高相关的危险因素。我们进行了一项前瞻性、观察性的单中心研究，纳入成年患者，检测其 HbA1c 水平，并记录患者的人口统计学特征和合并症。根据 HbA1c 水平将患者分为 HbA1C≤6.0%和 HbA1C≥6.1%两组，进行回归分析以识别相关因素。同时进行亚组分析，比较 HbA1C≥6.1%和 HbA1C≥8.0%两组患者的特征。共纳入 875 例患者，其中 182 例（20.8%）HbA1c≥6.1%，32 例（3.7%）HbA1c≥8.0%。与 HbA1C≤6.0%组相比，HbA1C≥6.1%组患者中印度裔人群比例较高[1.07（1.01-1.13），p=0.023]，体质量指数（BMI）较高（>27.5kg/m2）[1.07（1.02-1.11），p=0.002]，术前随机血糖较高[1.03（1.02-1.04），p<0.001]，患有糖尿病[1.85（1.75-1.96），p<0.001]和糖尿病前期[1.44（1.24-1.67），p<0.001]，且合并外周血管疾病[1.30（1.10-1.54），p=0.002]。HbA1C≥8.0%组患者年龄较大（>60 岁）[0.96（0.93-0.99），p=0.017]的比例较高。手术患者的 HbA1c 升高比例较高。针对择期手术高危患者进行术前 HbA1c 筛查，可降低成本，有助于针对性地利用医疗资源。
