Association of A1C and fasting plasma glucose levels with diabetic retinopathy prevalence in the U.S. population: Implications for diabetes diagnostic thresholds.
Association of A1C and fasting plasma glucose levels with diabetic retinopathy prevalence in the U.S. population: Implications for diabetes diagnostic thresholds.
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A1C 和空腹血糖水平与美国人群糖尿病视网膜病变患病率的关联：对糖尿病诊断阈值的影响。
DOI：
10.2337/dc09-0440
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发表时间：
2009-11
期刊：
影响因子：
16.2
通讯作者：
Saaddine JB
中科院分区：
文献类型：
--
作者：
Cheng YJ;Gregg EW;Geiss LS;Imperatore G;Williams DE;Zhang X;Albright AL;Cowie CC;Klein R;Saaddine JB
研究糖化血红蛋白(A1C)水平和空腹血糖(FPG)与美国人群中糖尿病视网膜病变的关系，并比较这两种血糖指标区分有无视网膜病变的人的能力。这项研究包括1,066名来自2005年至2006年全国健康和营养检查调查的年龄为40岁的≥。评估A1C、FPG和45°彩色数字视网膜图像。视网膜病变定义为早期治疗糖尿病视网膜病变研究严重程度量表上的≥-14水平。我们使用连接点回归来确定A1C和空腹血糖之间视网膜病变患病率的线性影响。视网膜病变的总患病率为11%，明显低于确诊糖尿病患者的患病率(36%)。A1C≥为5.5%或空腹血糖≥为5.8 mmoL/L者视网膜病变患病率显著升高，剔除使用降糖药的144人后，视网膜病变患病率增加最大的变化点分别为A1C 5.5%和空腹血糖7.0 mmoL/L，变异系数分别为15.6和28.8。根据受试者工作特征曲线下面积，A1C对视网膜病变的判别作用更强(0.71[95%可信区间0.66~0.76])，而空腹血糖(0.65[0.60~0.70]，P=0.009)。A1C、≥分别为5.5%和5.8mmoL/L的个体视网膜病变患病率上升幅度最大，A1C较≥更能区分视网膜病变的患病率。
To examine the association of A1C levels and fasting plasma glucose (FPG) with diabetic retinopathy in the U.S. population and to compare the ability of the two glycemic measures to discriminate between people with and without retinopathy. This study included 1,066 individuals aged ≥40 years from the 2005–2006 National Health and Nutrition Examination Survey. A1C, FPG, and 45° color digital retinal images were assessed. Retinopathy was defined as a level ≥14 on the Early Treatment Diabetic Retinopathy Study severity scale. We used joinpoint regression to identify linear inflections of prevalence of retinopathy in the association between A1C and FPG. The overall prevalence of retinopathy was 11%, which is appreciably lower than the prevalence in people with diagnosed diabetes (36%). There was a sharp increase in retinopathy prevalence in those with A1C ≥5.5% or FPG ≥5.8 mmol/l. After excluding 144 people using hypoglycemic medication, the change points for the greatest increase in retinopathy prevalence were A1C 5.5% and FPG 7.0 mmol/l. The coefficients of variation were 15.6 for A1C and 28.8 for FPG. Based on the areas under the receiver operating characteristic curves, A1C was a stronger discriminator of retinopathy (0.71 [95% CI 0.66–0.76]) than FPG (0.65 [0.60 – 0.70], P for difference = 0.009). The steepest increase in retinopathy prevalence occurs among individuals with A1C ≥5.5% and FPG ≥5.8 mmol/l. A1C discriminates prevalence of retinopathy better than FPG.
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影响因子：
120.7
作者：
Davidson, MB;Schriger, DL;Lorber, B
通讯作者：
Lorber, B
影响因子：
3.5
作者：
Holmes, Earle W.;Ersahin, Cagatay;Kahn, Stephen E.
通讯作者：
Kahn, Stephen E.
影响因子：
4.2
作者：
Wong, TY;Klein, R;Shea, S
通讯作者：
Shea, S
影响因子：
168.9
作者：
Wong, Tien Y.;Liew, Gerald;Shaw, Jonathan
通讯作者：
Shaw, Jonathan
影响因子：
16.2
作者：
Sacks DB;Arnold M;Bakris GL;Bruns DE;Horvath AR;Kirkman MS;Lernmark A;Metzger BE;Nathan DM;National Academy of Clinical Biochemistry;Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry
通讯作者：
Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry