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Keywords:

  • diabetes;
  • HbA1c threshold;
  • prediabetes
  • 糖尿病,糖化血红蛋白A1c诊断切点,糖尿病前期

Abstract

Objective

To identify the optimal threshold of HbA1c and to evaluate the predictive performance of HbA1c levels in diagnosing diabetes and prediabetes in a middle-aged and elderly Han Chinese population from northwest China.

Methods

In all, 3354 participants aged ≥40 years with no history of diabetes from northwest China were enrolled in the present cross-sectional study. All subjects underwent a 75-g oral glucose tolerance test (OGTT), as well as HbA1c testing. HbA1c thresholds for diagnosing diabetes and prediabetes were identified by the highest sum of sensitivity and specificity of each cut-off point, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of the HbA1c threshold.

Results

The mean (± SD) age of the participants was 57 ± 8 years, and 70.75% were women. Based on results of the OGTT, 1347 (40.16%) subjects had impaired fasting glucose and/or impaired glucose tolerance, and 725 (21.62%) had diabetes. The area under the ROC curve for detecting undiagnosed diabetes and prediabetes by HbA1c levels was 0.810 (95% confidence interval [CI] 0.796–0.823) and 0.732 (95% CI 0.717–0.747), respectively. HbA1c threshold of 6.4% and 6.1% produced the highest sum of sensitivity (60.00% and 61.49%) and specificity (87.33% and 73.24%) for diagnosing diabetes and prediabetes, respectively.

Conclusion

HbA1c is an effective and convenient method for diagnosing diabetes and prediabetes. HbA1c thresholds of 6.4% and 6.1% may be used as diagnostic criteria for diabetes and prediabetes, respectively, in the Han Chinese population living in northwest China.

摘要

目的

在中国西北地区中老年汉族人群中,探讨HbA1c用于诊断糖尿病和糖尿病前期的切点以及评价HbA1c其预测能力。

方法

本项横断面研究纳入了3354名年龄≥40岁、无糖尿病史的中国西北部地区的汉族人群,所有研究对象均接受了75 g口服葡萄糖耐量试验以及HbA1c的检测。HbA1c用于诊断糖尿病和糖尿病前期的切点通过敏感性和特异性之和的最大值来确定,并采用受试者工作特征曲线评价HbA1c用于诊断的准确性。

结果

研究人群的平均年龄(±SD)为57±8岁,女性占70.75%。根据OGTT试验结果,1347人(40.16%)有空腹血糖受损和/或糖耐量受损,725人(21.62%)患糖尿病。根据HbA1c水平检测无糖尿病和糖尿病前期时,ROC曲线下面积分别为0.810(95%CI 0.796–0.823)和0.732((95% CI 0.717–0.747)。根据HbA1c水平诊断糖尿病和糖尿病前期时,当HbA1c值分别为6.4%和6.1%时,其敏感性 (60.00% 和61.49%)和特异性 (87.33% and 73.24%)之和最大。

结论

HbA1c是一个方便、有效的诊断糖尿病和糖尿病前期的检测方法。HbA1c值为6.4% 和 6.1%可作为中国西北部地区汉族糖尿病和糖尿病前期的诊断切点。