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目的:探讨糖化血红蛋白(HbA1c)诊断农村中老年人群糖尿病(DM)及糖调节受损(IGR)的切点。方法:乐清市某社区为明确DM诊断而来院体检者和DM高危人群接受DM筛查者共749例,分为DM组141例、IGR组267例及糖代谢正常组(NGR组)341例,利用ROC曲线分析HbA1c诊断DM和IGR的最佳切点。结果:HbA1c诊断DM的最佳切点为6.1%,灵敏度和特异度分别为67.1%和83.7%。诊断IGR的最佳切点为5.8%,灵敏度和特异度分别为56.9%和56.1%。进一步分析显示,男性HbA1c诊断DM和IGR的最佳切点为6.1%和5.5%;而女性HbA1c诊断DM和IGR的最佳切点为6.3%和5.8%。结论:浙南农村中老年人群中,HbA1c诊断DM和IGR的最佳切点为6.1%和5.8%,低于美国糖尿病协会(ADA)的标准,且不同性别切点有差异。
Objective: To investigate the diagnostic value of glycosylated hemoglobin (HbA1c) in the diagnosis of diabetes mellitus (DM) and impaired glucose regulation (IGR) in rural middle-aged and elderly people. Methods: A total of 749 DM patients receiving DM screening from a hospital in Yueqing for DM diagnosis were divided into DM group (141 cases), IGR group (267 cases) and normal glucose metabolism group (NGR group) (341 cases) ROC curve analysis of HbA1c diagnosis of DM and IGR best cut point. Results: The optimal cut-off point for HbA1c diagnosis of DM was 6.1%, the sensitivity and specificity were 67.1% and 83.7% respectively. The best cut point for diagnosis of IGR was 5.8%, the sensitivity and specificity were 56.9% and 56.1% respectively. Further analysis showed that the best cut-off points for HbA1c diagnosis of DM and IGR in men were 6.1% and 5.5%, while the best cut-off points for HbA1c diagnosis in women and IGR were 6.3% and 5.8%. CONCLUSION: Among the rural middle-aged and elderly population in southern Zhejiang, HbA1c has the best cut point of 6.1% and 5.8% for diagnosing DM and IGR, which is lower than the standard of American Diabetes Association (ADA).