WHO与美国糖尿病学会糖尿病诊断标准异同的探讨

目的　探讨WHO与美国糖尿病学会 (ADA)糖尿病 (DM )诊断标准的异同及可能的原因。方法　对大庆地区 9832人糖尿病普查中做口服葡萄糖耐量试验 (OGTT)的 10 6 9人 ,分别以WHO与ADA诊断标准划分不同的血糖水平人群。分析人群分布的异同 ,并以Pearson相关分析探讨两种诊断标准的血糖异常人群不相符的原因。结果　WHO与ADA标准检出糖尿病患者分别为2 0 2例及 2 5 3例 ,与WHO标准比较 ,ADA标准诊断的DM符合率为 78.7% ,血糖正常人群符合率为 72 .3 % ,WHO检出的糖耐量低减 (IGT)人群中仅有 41.6 %被ADA判定为空腹血糖升高 (IFG) ,在空腹血浆葡萄糖 (FPG) <5 .83mmol/L的IGT及DM人群中 ,FPG均与 2小时血糖 (PG2h)不相关 ;在FPG≥ 5 .83mmol/L的人群中 ,FPG与PG2h相关。结论　ADA糖尿病诊断标准并非WHO诊断标准的替代物。WHO之IGT与ADA之IFG人群差异很大 ,以空腹血糖为标准找出与IGT完全相同的人群是不可能的

Accord and disaccord between WHO and American Diabetes Association diagnosis criteria of diabetes mellitus

Objective To explore the accord and thd disaccord between WHO and American Diabetes Association (ADA) criteria of diabetes mellitus and its possible reasons. Methods 1069 subjects from 9832 persons in a diabetic survey in Daqing district who underwent oral glucose tolerance test (OGTT) were grouped into different glucose level populations by WHO and ADA criteria. The accord and the disaccord between these populations were analyzed. Pearson correlation was used to explore why the corresponding groups under the two criteria did not agree with each other. Results 202 and 253 cases were diagnosed as diabetes by WHO and ADA criteria respectively. The coincidence percentage under the two criteria is 78.7% in diabetic population and 72.3% in normal population. Only 41.6% of the subjects with IGT was diagnosed as impaired fasting glucose (IFG) by ADA criterion. In IGT and DMpopulationwhosefastingplasma glucose (FPG) was less than 5.83 mmol/L, FPG and 2 hour plasma glucose (PG2h) were not significantly correlated. In the population whose FPG was more than 5.83 mmol/L,FPG and PG2h were significantly correlated. Conclusion ADA criterion of DM is not a substitute for WHO criterion. There is a remarkable disaccord between IGT and IFG. It would be impossible to diagnose the same population as IGT if FPG criterion was used.