2003 ADA空腹血糖受损诊断标准在中老年患者中的评估

目的分析2003年美国糖尿病学会（ADA）空腹血糖受损（IFG）的空腹血糖（FPG）诊断标准下调对中老年糖调节受45（IGR）人群检出率的影响，并探讨区分糖调节正常与受损的FPG理想切点。方法3219例50岁以上台州农村人群分层整群随机抽样调查，空腹测毛细血管血糖。若FPG5．6mmol/L做OGTF检查。结果IFG患病率按新诊断切点5．6mmol/L为10．15％，按原切点6．1mmol/L为1．24％，两组比较，差异有统计学意义（X^2=83．55，P〈0．05）；空腹血糖受损合并糖耐量受损（IGT）患病率按新诊断切点5．6mmol／L为6．14％．按原切点6．1mmol／L为3．26％，两组比较，差异有统计学意义（X^2=10．78，P〈0．05）。计算不同FPG切点诊断IGR的约登指数，最大值对应的FPG为5．7mmol／l。结论IFG诊断标准下调后，IFG、IFG＋IGT检出率明显增加：非DM中老年人群中诊断IGR的FPG理想截定点为5．7mmol/L．

Assessment of new diagnostic criteria for impaired fasting glucose in middle aged and senile patients

Objective To study the impact of new diagnostic criteria for impaired fasting glucose on the detection rate of impaired glucose regulation in middle aged and senile patients ,and to determine optimal FPG cutpoint for IGR diagnosis. Methods 3 219 subjects aged over 50 years had cluster stratified random sampling in Taizhou country. We detected capillary fasting plasma glucose, and when it ≥5.6mmol/1 oral 75 g glucose tolerance test （OGTT） would be made. Results IFG prevalence by new IFG diagnosis cutpoint （5.6mmol/L） was 10.15%,but only 1.24% by the cutpoint of 6.1mmol/L,there was a significant difference between the two groups （X^2=83.55 ,P〈0.05 ）; IGT prevalence by new IFG diagnosis cutpoint （5.6mmol/L）was 6.14%, but only 3.26% by the eutpoint of 6.1mmol/L,there was a significant difference between the two groups （X2=10.78,P〈0.05）; The optimal eutpoint and its corresponding Youden Index to diagnose IGR using FPG was 5.7mmol/L. Conclusions When IFG diagnostic criteria down regulation, the detection rate of IFG and IFG＋IGT are increased.In middle aged and senile population without DM, optimal FPG cutpoint for IGR diagnosis is 5.7mmol/L.