Fasting plasma glucose and HbA1c as risk factors for Type 2 diabetes
Fasting plasma glucose and HbA1c as risk factors for Type 2 diabetes
复制标题
DOI：
10.1111/j.1464-5491.2008.02572.x
复制
发表时间：
2008-10-01
影响因子：
3.5
通讯作者：
Akimoto, Kimihiko
中科院分区：
文献类型：
--
作者：
Inoue, Kazuo;Matsumoto, Masatoshi;Akimoto, Kimihiko
目的采用美国糖尿病协会（ADA）新的空腹血糖（FPG）标准和糖化血红蛋白（HbA（1c））下限临界值，探讨FPG和HbA（1c）联合预测糖尿病的价值（55 884人-年），基线时平均年龄为53.0岁。糖尿病的累积发病率（定义为FPG ≥ 7.0 mmol/l或临床诊断的糖尿病）被测量。结果在平均5.5年的随访期内，糖尿病的累积发病率和发病密度分别为3.7%（368例）和6.6/1000人年。空腹血糖受损（IFG）和HbA（1c）5.5-6.4%受试者的糖尿病累积发生率为24.8%（172/694人），而0.4%（25/6698人），2.5%（15/605人），7.6%空腹血糖（NFG）正常且HbA（1c）<5.5%，NFG和HbA（1c）5.5-6.4%，IFG和HbA（1c）<5.5%者156例。调整可能的混杂因素后，糖尿病的风险比为7.4（95%置信区间，4.70 - 11.74）对于NFG和HbA（1c）5.5- 6.4%的患者，14.4 IFG < 5.5%和HbA 1c <38.4%的患者的平均血糖（11.93 ~ 27.79 IFG和HbA（1c）5.5- 6.4%的患者，FPG和HbA（1c）的比值为（24.63 ~ 59.88）。在新的ADA标准FPG和比先前研究更低的HbA（1c）临界点下，确定了有进展为2型糖尿病风险的个体。
Aims We examined the value of combining fasting plasma glucose (FPG) and glycated haemoglobin (HbA(1c)) as a predictor of diabetes, using the new American Diabetes Association (ADA) criteria of FPG and lower cut-off point of HbA(1c).Methods A retrospective cohort study was conducted from 1998 to 2006, inclusive, in 10 042 persons (55 884 person-years), with a mean age of 53.0 years at baseline. The cumulative incidence of diabetes (defined either as an FPG >= 7.0 mmol/l or as clinically diagnosed diabetes) was measured.Results The cumulative incidence and incidence density of diabetes were 3.7% (368 cases) and 6.6/1000 person-years over a mean follow-up period of 5.5 years. The cumulative incidence of diabetes in subjects with impaired fasting glucose (IFG) and HbA(1c) 5.5-6.4% was 24.8% (172/694 persons) compared with 0.4% (25/6698 persons), 2.5% (15/605 persons), 7.6% (156/2045 persons) in those with normal fasting glucose (NFG) and HbA(1c) < 5.5%, NFG and HbA(1c) 5.5-6.4% and IFG and HbA(1c) < 5.5%, respectively. The hazard ratio for diabetes, adjusted for possible confounders, was 7.4 (95% confidence interval, 4.70 to 11.74) for those with NFG and HbA(1c) 5.5-6.4%, 14.4 (11.93 to 27.79) for those with IFG and HbA(1c) < 5.5% and 38.4 (24.63 to 59.88) for those with IFG and HbA(1c) 5.5-6.4%.Conclusions The combination of FPG and HbA(1c) identifies individuals who are at risk of progression to Type 2 diabetes at the new ADA criteria of FPG and a lower cut-off point of HbA(1c) than previous studies.