Is the measurement of glycated hemoglobin A1c alone an efficient screening test for undiagnosed diabetes? Japan National Diabetes Survey
Is the measurement of glycated hemoglobin A1c alone an efficient screening test for undiagnosed diabetes? Japan National Diabetes Survey
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DOI：
10.1016/j.diabres.2006.09.015
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发表时间：
2007-05-01
影响因子：
5.1
通讯作者：
Tajima, Naoko
中科院分区：
文献类型：
--
作者：
Nakagami, Tomoko;Tominaga, Makoto;Tajima, Naoko
这项研究的目的是根据1999年世界卫生组织的标准评估HbAlc对未诊断糖尿病(DM)的筛查试验特性及其与日本国家糖尿病调查可能和可能的DM的分界点的相关性：HbAlc>；5.6%和6.1%。本文对1904年Funagata镇35~89岁居民的糖化血红蛋白(HbAlc)预测未确诊糖尿病的筛查特性进行了检验，并与空腹血糖进行了比较。既往DM、未确诊DM和糖调节受损(IGR)的患病率分别为5.5%、6.0%和18.6%，而可能和可能DM的患病率分别为7.7%和5.4%。未确诊DM患者的受试者工作特征曲线下面积在糖化血红蛋白(0.856[95%CI：0.812~0.899])和空腹血糖(0.902[0.869~0.9361])之间相似。HbAlc为5.6%时，敏感性为56.5%，特异性为95.1%，阳性预测值为44.2%，阴性预测值为97.0%，超过临界点的人数比例为8.2%。真阳性试验中体重指数、空腹血糖、2小时血糖和糖化血红蛋白的平均水平显著高于假阴性试验，但高密度脂蛋白胆固醇的平均水平低于假阴性试验。在日本，单独测量HbAlc可能是筛查未诊断的DM的有效方法，对于筛查未诊断的DM的试验特性和预测血管并发症而言，5.6%的截断点可能是合适的。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
The aim of the study was to assess the screening test properties of HbAlc for undiagnosed diabetes (DM) according to the 1999-WHO criteria and its relevance of the Japan National Diabetes Survey Cut-off points for possible and probable DM: HbAlc >5.6 and 6.1%. Screening properties of HbAlc predicting undiagnosed DM was examined and compared with that of fasting plasma glucose (FPG) in 1904 Funagata-town inhabitants aged 35-89 years old. The prevalence of previous DM, undiagnosed DM, and impaired glucose regulation (IGR) were 5.5, 6.0, and 18.6%, while the prevalence of probable and possible DM were 7.7 and 5.4%. The area under the receiver operating characteristic curve for undiagnosed DM was similar between HbAlc (0.856 [95% CI: 0.812-0.899]) and FPG (0.902 [0.869-0.9361). HbAlc of 5.6% gave a sensitivity of 56.5%, a specificity of 95.1%, positive and negative predictive values of 44.2 and 97.0%, and a proportion of people above the cut-off point of 8.2%. True positive tests were significantly higher with mean levels of BMI, fasting, and 2-h plasma glucose, and HbAlc, but lower with mean levels of high-density-lipoprotein cholesterol than in false negative tests. The measurement of HbAlc alone may be efficient to screen undiagnosed DM and the cut-off point of 5.6% might be proper with respect to screening tests properties for undiagnosed DM, and prediction of vascular complications in Japan. (c) 2006 Elsevier Ireland Ltd. All rights reserved.