Comparison of fasting plasma glucose and haemoglobin A1c point-of-care tests in screening for diabetes and abnormal glucose regulation in a rural low income setting
Comparison of fasting plasma glucose and haemoglobin A1c point-of-care tests in screening for diabetes and abnormal glucose regulation in a rural low income setting
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DOI：
10.1016/j.diabres.2013.12.030
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发表时间：
2014-04-01
影响因子：
5.1
通讯作者：
Ostenson, Claes-Goran
中科院分区：
文献类型：
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作者：
Mayega, Roy William;Guwatudde, David;Ostenson, Claes-Goran
目的：糖化血红蛋白（HbA（1C））已被建议取代葡萄糖测试，以确定糖尿病和糖尿病前期。我们评估的协议之间的空腹血糖（FPG）和HbA（1C）快速测试在分类异常血糖调节（AGR），其效用为预防性筛查在农村African.Methods：一个以人口为基础的调查795人年龄在35-60岁，在乌干达的一个主要农村地区。使用On-Call（R）Plus血糖仪测量FPG，并使用世界卫生组织（WHO）和美国糖尿病协会（ADA）标准进行分类。HbA（1C）使用A1 cNow（R）试剂盒测量，并使用ADA标准进行分类。测量体重指数和血压。结果：使用HbA（1C），11.3%的参与者患有糖尿病，而FPG为4.8%。HbA（1C）定义的糖尿病前期患病率（26.4%）分别是使用ADA（21.8%）和WHO（10.1%）标准的FPG定义的糖尿病前期患病率的1.2倍和2.5倍。以FPG为参考，FPG和HbA（1C）在分类糖尿病状态方面的一致性为中度（Kappa = 22.9;曲线下面积（AUC）= 75%），而AGR的一致性较低（Kappa = 11.0; AUC = 59%）。然而，在阴性测试和具有2型糖尿病风险因素（肥胖、超重或高血压）的参与者中，一致性很高（超过90%）。HbA（1C）有更多的程序挑战比FPG.Conclusions：虽然在一般样本低，HbA（1C）和FPG之间的协议是优秀的人谁测试阴性与任何测试。因此，一个单一的测试可以确定大多数2型糖尿病的风险较低。经过培训的护士可以进行这些测试。(C)2014作者由Elsevier爱尔兰有限公司出版。保留所有权利。
Aims: Glycated haemoglobin (HbA(1C)) has been suggested to replace glucose tests in identifying diabetes and pre-diabetes. We assessed agreement between fasting plasma glucose (FPG) and HbA(1C) rapid tests in classifying abnormal glucose regulation (AGR), and their utility for preventive screening in rural Africa.Methods: A population-based survey of 795 people aged 35-60 years was conducted in a mainly rural district in Uganda. FPG was measured using On-Call (R) Plus glucometers, and classified using World Health Organization (WHO) and American Diabetes Association (ADA) criteria. HbA(1C) was measured using A1cNow (R) kits and classified using ADA criteria. Body mass index and blood pressure were measured. Percentage agreement between the two tests was computed.Results: Using HbA(1C), 11.3% of participants had diabetes compared with 4.8% for FPG. Prevalence of HbA(1C)-defined pre-diabetes (26.4%) was 1.2 times and 2.5 times higher than FPG-defined pre-diabetes using ADA (21.8%) and WHO (10.1%) criteria, respectively. With FPG as the reference, agreement between FPG and HbA(1C) in classifying diabetes status was moderate (Kappa = 22.9; Area Under the Curve (AUC) = 75%), while that for AGR was low (Kappa = 11.0; AUC = 59%). However, agreement was high (over 90%) among negative tests and among participants with risk factors for type 2 diabetes (obesity, overweight or hypertension). HbA(1C) had more procedural challenges than FPG.Conclusions: Although low in the general sample, agreement between HbA(1C) and FPG is excellent among persons who test negative with either test. A single test can therefore identify the majority at lower risk for type 2 diabetes. Nurses if trained can conduct these tests. (C) 2014 The Authors. Published by Elsevier Ireland Ltd. All rights reserved.