Glycated hemoglobin cannot yet be proposed as a screening tool for cystic fibrosis related diabetes
Glycated hemoglobin cannot yet be proposed as a screening tool for cystic fibrosis related diabetes
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DOI：
10.1016/j.jcf.2016.02.005
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发表时间：
2016-03-01
影响因子：
5.2
通讯作者：
Rabasa-Lhoret, Remi
中科院分区：
文献类型：
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作者：
Boudreau, Valerie;Coriati, Adele;Rabasa-Lhoret, Remi
随着囊性纤维化（CF）患者预期寿命的提高，CF相关糖尿病（CFRD）已成为主要并发症。口服葡萄糖耐量试验（OGTT）是检测它的标准试验。然而，OGTT的使用是有争议的，除了对患者和治疗团队的负担。目前正在研究寻找其他测试方法。虽然有些人认为糖化血红蛋白（HbA 1c）可能是一种有效的替代品，但我们过去的结果表明并非如此。一项新的分析涉及2004年至2015年期间207名患者的OGTT和HbA 1c值，提出HbA 1c ≥ 5.8%（39.9 mmol/mol）的下限阈值的敏感性为68.2%，特异性为60.5%。由于对需要OGTT的患者的识别具有如此的敏感性，如果将建议的HbA 1c值≥ 5.8%用作筛选工具来识别需要OGTT的患者，则将漏诊31.8%的CFRD诊断。考虑到我们的结果，我们认为HbA 1c不具备适合于面板堆石坝筛选试验的特征。(C)2016年欧洲囊性纤维化协会。由Elsevier B. V.出版，版权所有。
With improved life expectancy of cystic fibrosis (CF) patients, CF-related diabetes (CFRD) has become a major complication. The oral glucose tolerance test (OGTT) is the standard test to detect it. However, the use of OGTT is controversial, in addition to being a burden for patients and the treatment team. Research to find alternative ways of testing is ongoing. While some propose that glycated hemoglobin (HbA1c) may be an effective alternative, our past results suggest otherwise. A new analysis involving the OGTT and HbA1c values of 207 patients, between 2004 and 2015, proposes that the threshold of a lower value of HbA1c of >= 5.8%(39.9 mmol/mol) gives a sensitivity of 68.2% and a specificity of 60.5%. With such sensitivity to identify patients in need of an OGTT, 31.8% of CFRD diagnosis would be missed if the suggested HbA1c value of >= 5.8% was used as a screening tool to identify patients in need of OGTTs. Considering our results, we believe the HbA1c does not possess the characteristics of a suitable screening test for CFRD. (C) 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.