上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (9): 1077-.doi: 10.3969/j.issn.1674-8115.2019.09.022

• 论著·临床研究 • 上一篇    下一篇

1,5-脱水葡萄糖醇或糖化白蛋白联合空腹血糖筛查糖尿病的效率比较

苏杭，马晓静，应令雯，贺星星，朱玮，唐峻岭，王煜非，包玉倩，周健   

  1. 上海交通大学附属第六人民医院内分泌代谢科，上海市糖尿病研究所，上海市糖尿病重点实验室，上海市糖尿病临床医学中心，上海 200233
  • 出版日期:2019-09-28 发布日期:2019-11-02
  • 通讯作者: 周健，电子信箱：zhoujian@sjtu.edu.cn。
  • 作者简介:苏杭（1991—），女，住院医师，硕士；电子信箱： suhang911203@126.com。
  • 基金资助:
    上海市教育委员会高峰高原学科建设计划（20161430）

Efficiency comparison of fasting plasma glucose combined with 1,5-anhydroglucitol and combined with glycated albumin in diabetes mellitus screening

SU Hang, MA Xiao-jing, YING Ling-wen, HE Xing-xing, ZHU Wei, TANG Jun-ling, WANG Yu-fei, BAO Yu-qian, ZHOU Jian   

  1. Department of Endocrinology and Metabolism, Shanghai Sixth Peoples Hospital, Shanghai Jiao Tong University; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Clinical Center for Diabetes, Shanghai 200233, China
  • Online:2019-09-28 Published:2019-11-02
  • Supported by:
    Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Support, 20161430）。

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摘要： 目的 ·在中国糖尿病高危人群中分析及比较 1,5-脱水葡萄糖醇（ 1,5-anhydroglucitol，1,5-AG）及糖化白蛋白（ glycated albumin，GA）分别联合空腹血糖（ fasting plasma glucose，FPG）应用于糖尿病筛查的临床价值。方法 ·纳入糖尿病高危人群 701例，其中男性 324例，女性 377例。所有研究对象均行 75 g口服葡萄糖耐量试验。糖尿病诊断采用 2010年美国糖尿病学会的标准。分析 GA联合 FPG与 1,5-AG联合 FPG筛查糖尿病的敏感度、特异度和受试者工作特征曲线（ ROC曲线）下的面积（ AUC）。结果 · 701例研究对象中，有 350例（49.93%）确诊为糖尿病。 1,5-AG联合 FPG诊断敏感度达 84.29%，其特异度及 AUC分别为 91.45%和 0.939；GA联合 FPG诊断敏感度为 77.71%，特异度及 AUC分别为 90.88%和 0.932。2种筛查方法 AUC差异无统计学意义（P>0.05），但 1,5-AG联合 FPG的敏感度显著高于 GA联合 FPG（P0.001）。1,5-AG联合 FPG判断需行口服葡萄糖耐量试验者的比例为 27.82%，较单纯根据 FPG结果判断的比例降低了 11.27%，较根据 GA联合 FPG结果判断的比例降低了 2.57%。结论 ·在中国糖尿病高危人群中，血清 1,5-AG及 GA分别联合 FPG均可以提高糖尿病筛查效率；与 GA联合 FPG相比， 1,5-AG联合 FPG可能更具临床价值。

关键词: 糖尿病, 1, 5-脱水葡萄糖醇, 糖化白蛋白, 空腹血糖, 筛查

Abstract:

Objective · To analyze and compare the clinical value of serum 1,5-anhydroglucitol (1,5-AG) with glycated albumin (GA) combined with fasting plasma glucose (FPG), respectively, in screening diabetes mellitus in Chinese population at the risk of diabetes mellitus. Methods · A total of 701 subjects with high risk of diabetes were enrolled in this study, including 324 males and 377 females. All subjects underwent 75 g oral glucose tolerance test (OGTT). Diabetes was diagnosed according to the cut-off points of 2010 American Diabetes Association standards. The sensitivity, specificity and area under ROC curve (AUC) of GA combined with FPG and 1,5-AG combined with FPG in screening diabetes mellitus were analyzed. Results · Among 701 subjects, 350 (49.93%) cases were diagnosed as having diabetes mellitus. The sensitivity, specificity, and AUC of 1,5-AG combined with FPG were 84.29%, 91.45% and 0.939, respectively. The sensitivity of GA combined with FPG was 77.71%, and the specificity and AUC were 90.88% and 0.932, respectively. There was no significant difference in AUC between the two screening methods (P>0.05), but the sensitivity of 1,5-AG combined with FPG was higher than that of GA combined with FPG (P0.001). The proportion of the subjects in need of further OGTT judged1,5-AG combined with FPG was 27.82%, which was 11.27% lower than that judgedFPG alone, and 2.57% lower than that judgedGA combined with FPG. Conclusion · In Chinese population with high risk of diabetes mellitus, serum 1,5-AG or GA combined with FPG can improve the efficiency of diabetes screening. Compared with GA combined with FPG, 1,5-AG combined with FPG may have more clinical value.

Key words: diabetes mellitus, 1,5-anhydroglucitol (1,5-AG), glycated albumin (GA), fasting plasma glucose (FPG), screening

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