Hoskins P L, Handelsman D J, Hannelly T, Silink M, Yue D K, Turtle J R
Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.
Diabetes Res Clin Pract. 1987 Sep-Oct;3(5):257-67. doi: 10.1016/s0168-8227(87)80049-9.
Glycosylated hemoglobin was compared with fasting blood glucose as a screening test for diabetes mellitus and as an index of the severity of diabetes in biethnic (Melanesian and Indian) Fiji. Age-adjusted diabetes prevalence in the test sample was higher in Indians by either criterion. According to the hemoglobin A1 criterion, Melanesians had prevalence rates of 8.2% (males) and 15.8% (females) compared to 17.0% (males) and 24.3% (females) in Indians. In contrast, fasting blood glucose criteria (WHO) gave higher rates in each group. Hemoglobin A1 levels were higher overall in Indians and females. The predictive value of an elevated fasting blood glucose test for an elevated hemoglobin A1 was 20.0% in Melanesians and 60.7% in Indians while that of a normal fasting blood glucose test for a normal hemoglobin A1 was 89.4% in Melanesians and 89.3% in Indians. The proportion of Indians with elevated hemoglobin A1 who were severely hyperglycemic was almost 7 times higher (40.9% vs. 5.8%) than that of Melanesians. The ethnic difference in the predictive value of fasting blood glucose levels for hemoglobin A1 levels appears to be related to the greater severity of hyperglycemia of diabetic Indians compared to diabetic Melanesians. Hemoglobin A1 levels provide information on both the qualitative as well as quantitative differences in diabetes between ethnic groups.
在斐济的双种族人群（美拉尼西亚人和印度人）中，对糖化血红蛋白和空腹血糖进行了比较，以作为糖尿病的筛查试验以及糖尿病严重程度的指标。根据任一标准，测试样本中经年龄调整后的糖尿病患病率在印度人中更高。按照血红蛋白A1标准，美拉尼西亚男性患病率为8.2%，女性为15.8%，而印度男性为17.0%，女性为24.3%。相比之下，空腹血糖标准（世界卫生组织）在每组中给出的患病率更高。印度人和女性的血红蛋白A1水平总体上更高。空腹血糖升高对血红蛋白A1升高的预测价值在美拉尼西亚人中为20.0%，在印度人中为60.7%，而空腹血糖正常对血红蛋白A1正常的预测价值在美拉尼西亚人中为89.4%，在印度人中为89.3%。血红蛋白A1升高且严重高血糖的印度人比例几乎是美拉尼西亚人的7倍（40.9%对5.8%）。空腹血糖水平对血红蛋白A1水平的预测价值存在种族差异，这似乎与糖尿病印度人相比糖尿病美拉尼西亚人高血糖更为严重有关。血红蛋白A1水平提供了有关不同种族糖尿病在定性和定量方面差异的信息。
