糖化血红蛋白联合空腹血糖筛查2型糖尿病高危人群的临床意义

目的了解糖化血红蛋白(HbA1c)筛查糖尿病和糖代谢受损的敏感性并与空腹血糖(FBG)进行比较。方法对400例无糖尿病病史的糖尿病高危人群同时检测FBG和HbA1c,据空腹血糖水平分为三组:A1组:FBG<6.1 mmol/L,计336例,A2组:FBG 6.1-6.9 mmol/L,45例,A3组FBG≥7.0 mmol/L,19例。结果 (1)400例人群中,HbA1c≥6.0%,88例,异常率为22.0%;FBG≥6.1mmol/L,54例,异常率13.5.%,HbA1c的异常率高于FBG,P<0.05。(2)A1组HbA1c>≥6.0%,29例,占8.6%;A2组HbA1c≥6.0%,41例,占91.1%;A3组HbA1c≥6.0%,18例,占94.7%;(3)400例人群中,HbA1c≥6.0%或FBG≥6.1mmol/L,93例,异常率23.3%%。结论 HbA1c筛查糖尿病高危人群血糖异常的敏感性高于空腹血糖,两者联合检查有助发现更多糖代谢异常的患者。

The clinical significance of HbA1c combined with fasting blood glucose for screening glucose metabolism abnormality in high risk subjects of type 2 diabetes

Objective To investigate the clinical value of HbA1c combined with fasting blood glucose（FBG）in screening diabetes and impaired glucose regulation,and compare the sensitivity between HbA1c and FBG.Methods Fasting blood glucose and HbA1c were measured simultaneously in 400 non-diabetic subjects with high risk for type 2 diabetes.All subjects were divided into three groups according to FBG,i.e.group A1：FBG〈 6.1 mmol/L,n=336;group A2：FBG 6.1-6.9 mmol/L,n=45;group A3：FBG≥7.0 mmol/L,n=19.Results（1）Among the 400 subjects,the incidence rates of HbA1c≥6.0% and FBG≥6.1mmol/L were 22.0%（88/400）and 13.5%（54/400）,respectively.The difference were significant with P〈0.05.（2）The incidence rates of HbA1c more than and equal to 6.0% were 8.6%（29/336）,91.1%（41/45）and 94.7%（18/19）,respectively.（3）The rates of HbA1c HbA1c≥6.0% or FBG≥6.1mmol/L was 23.3% among the 400 subjects.Conclusion The sensitivity of HbA1c in screening abnormal glucose metabolism is higher than that of FBG,and combination test of HbA1c with FBG can help to find more people with abnormal glucose metabolism.