Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c.
Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c.
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DOI：
10.4093/dmj.2013.37.5.349
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发表时间：
2013-10
影响因子：
5.9
通讯作者：
Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association
中科院分区：
文献类型：
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作者：
Jeon JY;Ko SH;Kwon HS;Kim NH;Kim JH;Kim CS;Song KH;Won JC;Lim S;Choi SH;Jang MJ;Kim Y;Oh K;Kim DJ;Cha BY;Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association
由于进行口服葡萄糖耐量测试的不便以及血糖水平的日常变化，美国糖尿病协会推荐糖化血红蛋白（HbA1c）作为诊断糖尿病的方法。此外，韩国糖尿病协会还推荐使用HbA1c作为糖尿病的诊断测试。在这项研究中，我们仅根据空腹血糖 (FPG) 水平或结合 FPG 和 HbA1c 测试来评估糖尿病的患病率。对 2011 年韩国国家健康和营养检查调查 (KNHANES) 的数据进行了分析。在 5,811 名 30 岁或以上的受试者中，排除空腹时间 <8 小时、空腹血糖或 HbA1c 水平缺失值、医生之前诊断为糖尿病或当前使用抗糖尿病药物的数据后，选择了 5,020 名受试者。糖尿病的定义为 FPG ≥126 mg/dL、医生既往诊断为糖尿病、当前使用抗糖尿病药物和/或 HbA1c ≥6.5%。糖尿病前期定义为 FPG 为 100 至 125 mg/dL 和/或 HbA1c 为 5.7% 至 6.4%。当我们仅使用 FPG 时，糖尿病和糖尿病前期的患病率分别为 10.5%（男性 12.6%；女性 8.5%）和 19.3%（男性 23.8%；女性 14.9%）。当 HbA1c 被纳入诊断测试时，糖尿病和糖尿病前期的患病率分别增加至 12.4%（男性 14.5%；女性 10.4%）和 38.3%（男性 41%；女性 35.7%）。 HbA1c ≥6.5% 且空腹血糖水平 <126 mg/dL 的参与者年龄较大，估计肾小球滤过率较低。我们的结论是，仅使用空腹血糖水平可能会导致低估糖尿病和糖尿病前期。 HbA1c 是韩国患者可接受的糖尿病补充诊断测试。然而，需要国家标准化才能使用 HbA1c 作为糖尿病和糖尿病前期的诊断方法。
Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.