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目的探讨糖化血红蛋白(HbA_(1C))在中国成年人糖尿病前期筛查中的诊断价值。方法选取宁夏回族自治区有代表性的城区和郊区进行横断面调查,抽取不同年龄和职业的城乡居民共3362人(年龄18~83岁,男性1691人,女性1671人),进行问卷调查和体格检查,采集空腹静脉血测定其糖化血红蛋白((HbA_(1C)),空腹血糖(FPG)及各项生化指标,并对结果进行分析。结果初筛符合2010年ADA推荐糖尿病前期诊断标准者613人(18.2%),单独符合(HbA_(1C)标准((HbA_(1C) 5.7%~6.4%)和FPG标准(FPG 5.6-6.9 mmol/L)者分别为327人(9.7%)和428人(12.7%),同时符合(HbA_(1C)和FPG标准者为142人(4.2%)。(HbA_(1C)诊断FPG升高的R0C曲线下面积为0.743(P<0.001)。将空腹血糖受损(IFG)作为糖尿病前期诊断标准,以(HbA_(1C)5.7%为糖尿病前期诊断临界值,其诊断灵敏度为33.2%,特异度为93.7%,阳性预测值为43.4%,阴性预测值为90.6%。(HbA_(1C)与心血管风险因子存在显著相关性。结论 (HbA_(1C)在中国成人糖尿病前期的筛查诊断中具有良好的价值,且与心脏代谢性疾病紧密相关。
Objective To investigate the diagnostic value of glycosylated hemoglobin (HbA_ (1C)) in pre-diabetes screening of adults in China. Methods A cross-sectional survey was conducted on representative urban and suburban areas in Ningxia Hui Autonomous Region. A total of 3362 urban and rural residents (aged 18-83 years, 1691 males and 1671 females) of different ages and occupations were selected for questionnaire survey and physical examination (HbA_ (1C)), fasting blood glucose (FPG) and various biochemical parameters were measured and the results were analyzed.Results Primary screening of 613 people who met diagnostic criteria of ADA recommended pre-diabetes in 2010 (9.7%) and 428 persons (12.7%) with HbA_ (1C) alone (5.7% ~ 6.4% for HbA_ (1C) and FPG 5.6-6.9 mmol / (HbA_ (1C) and FPG) were 142 (4.2%). (The area under the curve of R0C of HbA_ (1C) diagnosis of elevated FPG was 0.743 (P <0.001), and impaired fasting glucose IFG) was used as the diagnostic criteria of pre-diabetes, the diagnostic sensitivity was 33.2%, the specificity was 93.7%, the positive predictive value was 43.4% and the negative predictive value was 90.6% with (HbA_ (1C) 5.7% as the pre-diabetes diagnostic threshold. (HbA_ (1C) and cardiovascular risk factors were significantly correlated.Conclusion (HbA_ (1C) in Chinese adults with pre-diabetes screening screening has good Value, and closely associated with cardiometabolic disease.