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目的探讨糖化血红蛋白(Hb A1c)在老年2型糖尿病中的诊断价值。方法 2013年从黄石市某街道随机抽取3个社区,选择60岁以上老年人共987例,行口服葡萄糖耐量试验(OGTT),分别测定血糖(FBG)、餐后2h血糖(2h PBG)和Hb A1c,并比较Hb A1c和OGTT诊断老年糖尿病的最佳临界值。结果 987例受检者中,共检测出糖尿病患者300例,占30.4%;Hb A1c诊断老年糖尿病的最佳临界值为6.0%,此时曲线下面积(AUC)为83.8%,灵敏度为89.5%,特异度为72.3%;OGTT诊断老年糖尿病的最佳临界值为10.99mmol/L,此时AUC为97.4%,灵敏度为96.5%,特异度为79.9%。两者AUC比较,差异有统计学意义(P<0.05)。结论 Hb A1c对老年2型糖尿病的有一定的诊断价值,但更加明确的诊断还应结合传统检测指标。
Objective To investigate the diagnostic value of glycosylated hemoglobin (Hb A1c) in type 2 diabetes mellitus in the elderly. Methods In 2013, three communities were randomly selected from a street in Huangshi City. A total of 987 elderly people over the age of 60 were selected for oral glucose tolerance test (OGTT). Blood glucose (FBG), postprandial 2h PBG and Hb A1c, and to compare the best cut-off value of Hb A1c and OGTT in diagnosis of senile diabetes. Results A total of 987 diabetic patients were detected in 300 cases (30.4%). The best cutoff value of Hb A1c in diagnosing diabetes was 6.0%. The area under the curve (AUC) was 83.8% and the sensitivity was 89.5% , And the specificity was 72.3%. The best cutoff value of OGTT for diagnosis of senile diabetes was 10.99mmol / L, the AUC was 97.4%, the sensitivity was 96.5% and the specificity was 79.9%. There was significant difference between AUC and AUC (P <0.05). Conclusion Hb A1c has certain diagnostic value for type 2 diabetes in the elderly, but a more definite diagnosis should be combined with the traditional detection of indicators.