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目的评价青岛糖尿病危险评分表(QDRS)筛查2型糖尿病(T2DM)的效果,为T2DM的预防控制提供参考依据。方法对山东省青岛市2009年糖尿病项目中自报无T2DM的4 426人进行口服葡萄糖耐量试验(OGTT),于2012年对其中3 843名未患T2DM者进行随访调查,通过构建受试者工作特征曲线(ROC)模型,比较QDRS与空腹血浆血糖(FPG)和中国糖尿病危险评分表(CDRS)筛查无症状T2DM人群的灵敏度、特异度和约登指数,并在2 295名3年随访人群中验证该工具的可靠性。结果青岛市2009年4 426名基线人群的T2DM发病率为13.2%,2012年2 295名随访人群的T2DM发病率为7.9%;2009年FPG、QDRS和CDRS筛查T2DM的曲线下面积(AUC)分别为0.87(95%CI=0.85~0.89)、0.68(95%CI=0.66~0.70)和0.70(95%CI=0.68~0.72),最佳切点(FPG≥6.4 mmol/L、QDRS≥14分和CDRS≥30分)的灵敏度分别为72.0%、73.2%和66.2%,特异度分别为91.2%、66.5%和63.8%,约登指数分别为0.63、0.30和0.30;2012年FPG、QDRS和CDRS筛查T2DM的AUC分别为0.83(95%CI=0.79~0.87)、0.62(95%CI=0.57~0.66)和0.65(95%CI=0.61~0.70),最佳切点的灵敏度分别为51.7%、75.6%和73.8%,特异度分别为95.7%、41.0%和47.9%,约登指数分别为0.47、0.12和0.21;2009年和2012年QDRS与FPG、CDRS预测新发糖尿病效能比较,差异均无统计学意义(均P>0.05)。结论QDRS可以作为预测T2DM人群的可靠筛查工具。
Objective To evaluate the effect of Qingdao Diabetes Risk Scale (QDRS) in screening type 2 diabetes mellitus (T2DM) and provide a reference for the prevention and control of T2DM. Methods Oral glucose tolerance test (OGTT) was conducted on 4 426 individuals who reported no T2DM in Qingdao Diabetes Project in Shandong Province in Shandong Province in 2012 and 3 843 patients without T2DM were followed up in 2012. By constructing the work of the subjects (ROC) model was used to compare the sensitivity, specificity and Youden index of QDRS with fasting plasma glucose (FPG) and Chinese Diabetes risk score (CDRS) in screening asymptomatic T2DM patients and in 2 295 three-year follow-up population Verify the reliability of the tool. Results The prevalence of T2DM in 4226 people in baseline population in Qingdao was 13.2% in 2009, and the incidence of T2DM was 7.9% in 2 295 respondents in 2012. The area under the curve (AUC) of T2DM screening by FPG, QDRS and CDRS in 2009, (95% CI = 0.85-0.89), 0.68 (95% CI = 0.66-0.70) and 0.70 (95% CI 0.68-0.72) respectively. The best cut point (FPG≥6.4 mmol / L, QDRS≥14 And CDRS≥30) were 72.0%, 73.2% and 66.2% respectively, with specificity of 91.2%, 66.5% and 63.8% respectively, and the Youden index were 0.63, 0.30 and 0.30, respectively. FPG, QDRS and The AUC of CDRS screening for T2DM were 0.83 (95% CI = 0.79-0.87), 0.62 (95% CI = 0.57-0.66) and 0.65 (95% CI 0.61-0.70), respectively. The sensitivity of the best cut point was 51.7 %, 75.6% and 73.8% respectively, and the specificity was 95.7%, 41.0% and 47.9%, respectively, and the Youden index was 0.47, 0.12 and 0.21 respectively. The comparison between QDRS, FPG and CDRS in 2009 and 2012 predicted the new-onset diabetes mellitus, No statistical significance (all P> 0.05). Conclusion QDRS can be used as a reliable screening tool to predict T2DM population.