Cystic Fibrosis-Related Diabetes Screening in Adults: A Gap Analysis and Evaluation of Accuracy of Glycated Hemoglobin Levels
Cystic Fibrosis-Related Diabetes Screening in Adults: A Gap Analysis and Evaluation of Accuracy of Glycated Hemoglobin Levels
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DOI：
10.1016/j.jcjd.2018.04.008
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发表时间：
2019-02-01
影响因子：
2.5
通讯作者：
Tullis, Elizabeth
中科院分区：
文献类型：
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作者：
Gilmour, Julie A.;Sykes, Jenna;Tullis, Elizabeth
目标：我们试图通过三级医疗诊所的口服葡萄糖耐量试验 (OGTT) 来确定囊性纤维化相关糖尿病 (CFRD) 筛查方面的差距。我们的第二个目标是确定糖化血红蛋白水平 (A1C) 阈值，以优化预测 CFRD 和糖耐量受损的敏感性和特异性。方法：这项回顾性研究使用了多伦多囊性纤维化 (CF) 数据库中的数据。研究人群包括2008年1月1日至2015年12月31日期间在CF诊所就诊的所有成年（>=18岁）患者。描述性统计数据用于OGTT差距分析：CFRD筛查率每年计算为接受OGTT的合格患者的比例。以 OGTT 为参考标准，以 A1C 水平为指标测试，对 320 名患者的样本量计算敏感性和特异性。 结果：平均每年有 48.5% 的符合条件的个体通过 OGTT 进行 CFRD 筛查。 5.5% 的 A1C 阈值诊断 CFRD（和糖耐量受损）的敏感性分别为 91.8% (75%) 和 34.1% (33.4%) 的特异性。 229 名 A1C 水平患者中
Objectives: We sought to identify the gap in cystic fibrosis-related diabetes (CFRD) screening by means of an oral glucose tolerance test (OGTT) in our tertiary care clinic. Our second aim was to identify the glycated hemoglobin level (A1C) threshold that optimizes sensitivity and specificity for predicting CFRD and impaired glucose tolerance.Methods: This retrospective study used data housed in the Toronto cystic fibrosis (CF) database. The study population included all adult (>= 18 years of age) patients seen in the CF clinic between January 1, 2008, and December 31, 2015. Descriptive statistics were used for the OGTT gap analysis: the CFRD screening rate was calculated on an annual basis as the proportion of eligible patients who received OGTTs. Sensitivity and specificity were calculated using OGTTs as the reference standard and A1C levels as the index test on a sample size of 320 patients.Results: On average, 48.5% of eligible individuals were screened each year for CFRD by OGTTs. A1C thresholds of 5.5% had a sensitivity of 91.8% (75%) and a specificity of 34.1% (33.4%) for the diagnosis of CFRD (and impaired glucose tolerance), respectively. Of the 229 patients with A1C levels