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血清脱水葡萄糖醇能否替代口服葡萄糖耐量试验用于糖尿病筛查?毛里求斯非传染性疾病研究小组。

Is serum anhydroglucitol an alternative to the oral glucose tolerance test for diabetes screening? The Mauritius Noncommunicable Diseases Study Group.

作者信息

Robertson D A, Alberti K G, Dowse G K, Zimmet P, Tuomilehto J, Gareeboo H

机构信息

Human Diabetes and Metabolism Research Centre, Newcastle upon Tyne, UK.

出版信息

Diabet Med. 1993 Jan-Feb;10(1):56-60. doi: 10.1111/j.1464-5491.1993.tb01997.x.

Abstract

The oral glucose tolerance test is inconvenient for diabetes screening. In clinical studies a reduced serum anhydroglucitol level has proved to be a sensitive and specific test for diabetes. A new minicolumn enzymatic method which is simple and robust makes use in population screening feasible. The aim of our study was to assess the usefulness of a single measurement of anhydroglucitol to screen for diabetes and impaired glucose tolerance. Assays were performed on samples taken from 227 Mauritian Chinese subjects at the time of glucose tolerance testing. Subjects had normal glucose tolerance (n = 82), impaired glucose tolerance (n = 76), newly diagnosed diabetes (n = 38), and known diabetes (n = 31). Anhydroglucitol concentrations (mean +/- SD) were similar for normal and impaired glucose tolerance subjects (23.7 +/- 8.2 vs 23.4 +/- 8.6 mg l-1). Although the differences between normal and newly diagnosed diabetes (15.0 +/- 11.0 mg l-1) and known diabetic subjects (11.8 +/- 10.6 mg l-1) were significant (p < 0.001), diagnostic sensitivity and specificity were poor. We conclude that measurement of serum anhydroglucitol is not suitable for screening for the diagnoses of impaired glucose tolerance and diabetes.

摘要

口服葡萄糖耐量试验对于糖尿病筛查而言并不方便。在临床研究中,血清脱水利尿醇水平降低已被证明是一种针对糖尿病的敏感且特异的检测方法。一种简单且可靠的新型微型柱酶法使得在人群筛查中得以应用。我们研究的目的是评估单次测量脱水利尿醇对筛查糖尿病和糖耐量受损的效用。在进行葡萄糖耐量测试时,对227名毛里求斯华裔受试者采集的样本进行了检测。受试者分别有糖耐量正常者(n = 82)、糖耐量受损者(n = 76)、新诊断的糖尿病患者(n = 38)以及已知糖尿病患者(n = 31)。糖耐量正常和受损的受试者脱水利尿醇浓度(均值±标准差)相似(分别为23.7±8.2与23.4±8.6 mg l-1)。尽管糖耐量正常者与新诊断糖尿病患者(15.0±11.0 mg l-1)以及已知糖尿病患者(11.8±10.6 mg l-1)之间的差异具有显著性(p < 0.001),但其诊断敏感性和特异性较差。我们得出结论,血清脱水利尿醇的测量不适用于筛查糖耐量受损和糖尿病的诊断。

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