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老年人群糖尿病的筛查方法

[Screening methods for diabetes mellitus in aged group].

作者信息

Ito C, Kasagi F

机构信息

Hiroshima A-bomb Casualty Council Health Management Center.

出版信息

Nihon Ronen Igakkai Zasshi. 1993 Apr;30(4):288-92. doi: 10.3143/geriatrics.30.288.

DOI:10.3143/geriatrics.30.288
PMID:8315847
Abstract

There are many methods of screening for diabetes mellitus, for example, blood glucose test, urine sugar test, hemoglobin A1c, fructosamine etc. For the purpose of more efficient screening of diabetes mellitus in elderly groups, these data were analyzed to evaluate validity and ability to estimate prognosis. 1) Validity for screening based on diabetic type was analyzed in 27,074 cases. For screening with the standard level of fasting plasma glucose (FPG) > or = 120 mg/dl, sensitivity was 70.5%, specificity, 94.5%, predictive value, 89.0%, hemoglobin A1c > or = 6.5%, 62.7%, 91.2%, 81.5%, respectively, and fructosamine > or = 290 mumol/L, 54.1%, 92.3%, 78.1%, respectively. FPG had the highest validity. Comparison of validity between the > or = 65-yr group and the < or = 55-yr group was mode. There was significant difference in specificity but sensitivity and predictive value were lower in the > or = 65-yr group. 2) Mean blood glucose levels (BG) +/- S.D. by time after meal were studied. Fasting BG was 84.8 +/- 9.8 mg/dl, 0.5-1 hr. BG after meal, 100.8 +/- 24.5 mg/dl, and 4.5 hr or more, 84.1 +/- 12.8 mg/dl. Based on this data, standard levels for screening based on diabetic type using random blood glucose levels for 0.5-1 hr BG after meals were > or = 130 mg/dl, 1.5-2 hr BG > or = 120 mg/dl, and 3.5 hr or more BG and FBG > or = 100 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

糖尿病有多种筛查方法,例如血糖检测、尿糖检测、糖化血红蛋白、果糖胺等。为了更有效地筛查老年人群中的糖尿病,对这些数据进行分析以评估其有效性和预后估计能力。1)在27074例病例中分析了基于糖尿病类型的筛查有效性。以空腹血糖(FPG)≥120mg/dl为标准水平进行筛查时,敏感性为70.5%,特异性为94.5%,预测值为89.0%;糖化血红蛋白≥6.5%时,敏感性为62.7%,特异性为91.2%,预测值为81.5%;果糖胺≥290μmol/L时,敏感性为54.1%,特异性为92.3%,预测值为78.1%。FPG的有效性最高。对≥65岁组和≤55岁组的有效性进行了比较。特异性存在显著差异,但≥65岁组的敏感性和预测值较低。2)研究了餐后不同时间点的平均血糖水平(BG)±标准差。空腹血糖为84.8±9.8mg/dl,餐后0.5 - 1小时血糖为100.8±24.5mg/dl,4.5小时及以上血糖为84.1±12.8mg/dl。基于此数据,餐后0.5 - 1小时随机血糖水平用于基于糖尿病类型筛查的标准水平为≥130mg/dl,1.5 - 2小时血糖≥120mg/dl,3.5小时及以上血糖和空腹血糖≥100mg/dl。(摘要截断于250字)

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