Simmons D, Williams D R
Sheikh Rashid Diabetes Unit, Radcliffe Infirmary, Oxford, UK.
Diabet Med. 1994 Nov;11(9):830-5. doi: 10.1111/j.1464-5491.1994.tb00364.x.
Screening asymptomatic subjects for diabetes is often undertaken using a random capillary whole blood sample for glucose estimation. The test characteristics of this method for screening were assessed using a glucose oxidase method among 3425 Europeans and 3469 South Asians who gave such a sample during the Coventry Diabetes Study, a house-to-house diabetes prevalence study. Glucose tolerance test were performed on those with a high blood glucose and 10% of others. Previously undiagnosed diabetes was found in 73 Europeans and 110 South Asians. If the random glucose was > or = 7.0 mmol l-1, 8.0% of Europeans and 6.7% of South Asians would need a further diagnostic test and the sensitivity of this cut-off was 51.7 (95.0% CI: 43.5-59.9)% in Europeans and 68.4 (60.6-76.2)% in South Asians. Sensitivity was increased in South Asians but not Europeans by defining the time since last meal (South Asians < 2 h: 83.9 (72.3-92.0)%; > or = 2 h: 54.9 (42.7-66.8)%). Sensitivity was poorest among Europeans aged > or = 65 years (40-64 years 69.0 (49.2-84.7)%, > or = 65 years 49.4 (38.2-60.6)%). Screening asymptomatic individuals using an isolated capillary random whole blood glucose measure is a poor test for diabetes, although slight improvement can be obtained among South Asians by testing within 2 h of a meal.
对无症状受试者进行糖尿病筛查时,通常采用随机毛细血管全血样本进行血糖测定。在考文垂糖尿病研究(一项逐户进行的糖尿病患病率研究)中,对3425名欧洲人和3469名南亚人采用葡萄糖氧化酶法评估了这种筛查方法的检测特性,这些人提供了这样一份样本。对血糖高的人和其他10%的人进行了葡萄糖耐量试验。在73名欧洲人和110名南亚人中发现了先前未被诊断出的糖尿病。如果随机血糖≥7.0 mmol/L,8.0%的欧洲人和6.7%的南亚人需要进一步的诊断测试,该临界值在欧洲人的敏感性为51.7(95.0%CI:43.5 - 59.9)%,在南亚人为68.4(60.6 - 76.2)%。通过定义距上次进餐的时间,南亚人的敏感性增加了,但欧洲人没有(南亚人<2小时:83.9(72.3 - 92.0)%;≥2小时:54.9(42.7 - 66.8)%)。在≥65岁的欧洲人中敏感性最差(40 - 64岁为69.0(49.2 - 84.7)%,≥65岁为49.4(38.2 - 60.6)%)。使用单独的毛细血管随机全血葡萄糖测量来筛查无症状个体对糖尿病来说是一种较差的检测方法,不过在南亚人中通过在进餐2小时内进行检测可略有改善。