Moving to an A1C-based diagnosis of diabetes has a different impact on prevalence in different ethnic groups.
Moving to an A1C-based diagnosis of diabetes has a different impact on prevalence in different ethnic groups.
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DOI：
10.2337/dc09-1843
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发表时间：
2010-03
期刊：
影响因子：
16.2
通讯作者：
Vistisen D
中科院分区：
文献类型：
--
作者：
Christensen DL;Witte DR;Kaduka L;Jørgensen ME;Borch-Johnsen K;Mohan V;Shaw JE;Tabák AG;Vistisen D
比较筛查检测的糖尿病患病率和诊断一致性程度（按种族划分）与当前基于口服葡萄糖耐量试验（OGTT）和新提出的基于A1 C的诊断标准。来自丹麦、英国、在澳大利亚、格陵兰岛、肯尼亚和印度，基于OGTT对糖尿病病例受试者中A1 C ≥6.5%的概率进行了检测。通过logistic回归分析研究中心之间的概率差异，调整相关混杂因素。在6项研究中，有4项研究采用基于A1 C的诊断标准，糖尿病患病率较低。各研究中心OGTT诊断病例受试者中A1 C ≥6.5%的概率范围很广（17.0-78.0%）。英国不同种族亚组之间诊断一致性的差异这些研究与国家间比较的规模相同。转变为基于A1 C的糖尿病诊断将对不同种族和人群的糖尿病患病率产生显著不同的后果。
To compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria. Six studies (1999–2009) from Denmark, the U.K., Australia, Greenland, Kenya, and India were tested for the probability of an A1C ≥6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. Diabetes prevalence was lower with the A1C-based diagnostic criteria in four of six studies. The probability of an A1C ≥6.5% among OGTT-diagnosed case subjects ranged widely (17.0–78.0%) by study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. study were of the same magnitude as between-country comparisons. A shift to an A1C-based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations.