| 张云良,郭淑芹,马文彬,王君,白广芹,杨茜,提素芳,马锐,魏瑞璞.刘文宣,李哲,杨磊,刘殿武,李志红.指尖毛细血管空腹血糖筛查糖尿病和糖尿病前期的切点及应用[J].中华流行病学杂志,2010,31(10):1174-1178 |
| 指尖毛细血管空腹血糖筛查糖尿病和糖尿病前期的切点及应用 |
| Cut-offpoints of fasting fingertip capillary blood glucose for detecting both undiagnosed diabetes and pre-diabetes |
| 收稿日期:2010-03-02 出版日期:2014-09-18 |
| DOI：10.3760/cma.j.issn.0254-6450.2010.10.023 |
| 中文关键词: 糖尿病 空腹血糖受损 糖耐量低减 指尖毛细血管空腹血糖 切点 |
| 英文关键词: Diabetes mellitus Impaired fasting glucose Impaired glucose tolerance Fingertip capillary blood glucose：Cut.Ofrpoint |
| 基金项目:河北省医学科学研究重点课题计划(08009) |
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| 目的 探讨指尖毛细血管空腹血糖(指尖FPG)筛检社区45岁以上人群糖尿病和糖 尿病前期[空腹血糖受损(IFG)、糖耐量低减(1GT)]的切点，为人群普查提供依据。方法 随机整 群抽取保定市3个社区，以社区内45岁以上居民3250人为筛查对象。对指尖FPG≥5.1 mmol／L 者进行75 g口服葡萄糖耐量试验(oGTT)，测空腹m糖及服糖2 h静脉血浆血糖(2hPG)，诊断糖尿 病和糖尿病前期。应用受试者T作(ROC)曲线确定糖尿病及IFG、IGT的切点。判断诊断价值。 结果 检出糖尿病230例(7.3％)，IFG 166例(5.2％)，IGT204例(6.7％)；以指尖FPG为测试 变量，以是否FPG≥7.0 mmoi／L及或2hPG≥11.1 mmol／L为说明变量ROC曲线分析，曲线下面 积为0.905，最佳切点为6.0mmol／L，最大灵敏度和特异度分别是78.O％和89.3％；以是否FPG< 5.6 mmoi／L、是否FPG<7.0 mmol／L及7.8 mmoFL≤2hPG≤11.1 mmol／L为说明变量ROC曲线分 析，曲线下面积分别为0.633、0.719。最佳切点均为5.7 mmol／L，灵敏度和特异度均较低(50.3％、 28.O％；60.8％、28.O％)。结论 用指尖FPG 6.0 mmol／L为切点筛查45岁以上人群糖尿病，相对可 靠；但指尖FPG筛查IFG、IGT不可靠。指尖FPG筛查社区人群简便、快捷，有一定的应用意义。 |
| 英文摘要: |
| Objective To determine the efficient cut-ofF points of fasting fingertip blood glucose test for undiagnosed diabetes meilitus(DM)。impaired glucose tolerance(IGT)，and impaired fasting glucose(IFG)in community-based residents aged above 45 years old.Methods A cluster-randomized study was conducted from May 2008 to January 2009.A total of 3250 subjects aged above 45 years in two communities of Baoding city received questionnaire investigation and tested for fingertip blood glucose.Those subjects whose capillary blood glucose level≥5.1 m.moFL were subjected to 75 g ol-al glucose tolerance test.Undiagnosed diabetes mellitus and pre-diabetes WgTe identified by fasting plasma glucose and OGTT.In this study.the cut-ofr points of fasting capillary blood glucose for detecting undiagnosed diabetes and pre-diabetes were evaluated，using receiver operator characteristic curve(ROC).Results Of l 35 l subjects that having had oral glucose tolerance test，230 cases were diagnosed as diabetes mellitus(7.3％)，166 cases(5.2％)as IFG，and 204(6.7％)as IGT under fasting capillary blood glucose as test variable and state vailables according to the following criteria.(1)FPG≥7.0 inmol／L or／and 2hPG≥11.1 mnloI／L(2)FPG<5.6 mmol／L (3)FPG<7.0 mmoi／L and 7.8 mnlo儿≤2hPG≤11.1 mlnoI／L。al'eas under three ROC cul'ves were 0.905，0.633 and 0.719。respectively.The cut.0ffvalues ofscreening for undiagnosed DM，IGT and IFG were 6.0 mmol／L。5.7 mmoI／L，and 5.7 mmol／L。respectively.When cut.0ff value of screening for undiagnosed DM was 6.0 mmoI／L.the maximal sensitivity Was 78.0％and specificity Was 89.3％. BUt there were both lower sensitivity and specificity in screening for IFG and IGT according to the best predicting value(5.7 mmoI／L)from the ROC curves(50.3％and 28.O％115.60.8％and 28.O％).Conclusion Fasting capillary blood glucose with the lower cut.point of 6.0 mmoⅥ。in screening for tmdiagnosed diabetes mellitus alone，was relatively reliable。whereas for both IFG and IGT the fasting fingertip blood glucose tests were fallible.It Was convenient and could be used in screening the DM at the community level. |
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