空腹血糖及OGTT1h血糖对糖尿病诊断意义的比较

目的：比较空腹血糖（FPG）及口服糖耐量试验（OGTT）1h血糖（PG）诊断糖尿病灵敏度和特异度的差异及其与胰岛B细胞功能及胰岛素抵抗的关系。方法：选取需行OGTF的4430名受试者。用接受者工作特征（ROC）曲线计算出OGTFlhPG诊断糖尿病的最佳切点，后将其与FPG进行比较分析。结果：以糖尿病为参考标准，ROC曲线得出OGTFIhPG诊断糖尿病的最佳切点为12．94mmol／L。以OGTF2hPG≥11．1mmol／L为诊断糖尿病的金标准，FPG≥17．0mmol/L诊断糖尿病的灵敏度为62．91％，特异度为96．46％；OGTT1hPG≥12．94mmol／L诊断糖尿病的灵敏度为83．62％，特异度为88．42％。FPG和1hPG与胰岛素抵抗指数（HOMA—IR）呈正相关（P〈0．01）；与HOMA—B呈负相关（P〈0.01）；与胰岛素生成指数呈负相关（P〈0．01）。结论：单纯用FPG诊断糖尿病漏诊率高，1hPG更有诊断价值，且FPG和1hPG可一定程度反映胰岛B细胞功能及胰岛素抵抗情况。

The comparison of fasting plasma glucose and 1-hour plasma glucose to diagnose diabetes mellitus

Objective： To compare the sensitivity and specificity of fasting plasma glucose（FPG） and 1- hour plasma glucose （ lhPG）to diagnose diabetes mellitus （DM）, and the relation of them with islet B cell function and insulin resistance. Methods： 4 430 objects who need an OGTI＇ were recruited. The optimal cutoff value of I hPG was calculated by ROC curve , and compared with FPG. Results： According to ROC results, to diagnose type 2 DM, the optimal cutoff value of lh PG was 12.94 mmol/L. Classifying OGqT 2hPG ≥11.1 mmol/L as gold standard of diagnosing diabetes mellitus, the sensitivity of FPG ≥7.0mmol/L to diagnose DM was 62.91%,the specificity was 94,46%; the sensitivity of lhPG I〉 12.94 mmol/L to diagnose DM was 83.62% ,the specificity was 88.42%. There was a negative correlation between FPG, lhPG and insulingenie index, HOMA-B （P〈0.01） and a positive correlation between lhPG and HOMA-IR （P〈0.01）. Conclusion： By FPG alone, there is high rate of missed diagnosis of DM, lhPG have more diagnostic value, and they all can reflect islet B cell function and insulin resistance in some extent.