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目的评价糖尿病危险积分(DRS)对糖尿病(DM)一线筛查的价值。方法 259例既往未诊断DM的受试人群进行问卷调查和查体,分别计算芬兰DRS(F-DRS)和中国DRS(C-DRS),间隔2～3周重复进行两次OGTT。结果两次OGTT结果显示为正常、IFG或IGT、IFG合并IGT、DM组的F-DRS和C-DRS分别为5.6521±4.53和13.97±9.84、7.60±3.85和20.59±8.87、8.90±3.77和23.07±8.56、11.67±5.05和26.31±7.87(P<0.05).ROC曲线显示F-DRS切点为9时,以单次OGTT结果和两次OGTT结果评价的敏感性分别为63.8%和67.3%,特异性为60.8%和62.7%,若敏感性达到85%时的切点分别为6.0和6.5;C-DRS切点为18时,以单次OGTT结果和两次OGTT结果评价的敏感性分别为83.0%和85.5%,特异性为49.1%和51.0%,敏感性达到85%时的切点均为19.5。对F-DRS≥9的人群再进行OGTT检测DM的诊断率为67%,33%患者漏诊,而49%的非DM患者可以免做OGTT。对C-DRS≥18的人群再进行OGTT检测DM的诊断率达85%,15%患者漏诊,而39%的非DM患者免做OGTT。结论DRS与IGT程度具有很好的一致性;C-DRS比F-DRS敏感性更高,更适合于中国人群DM的一线筛查。
Objective To evaluate the value of diabetes risk score (DRS) in the first-line screening of diabetes mellitus (DM). Methods A total of 259 previously untreated DM subjects were investigated by questionnaire and physical examination. Finnish DRS (F-DRS) and Chinese DRS (C-DRS) were calculated, and OGTT was repeated twice every 2 to 3 weeks. Results The results of two OGTTs showed normal. The F-DRS and C-DRS of IFG or IGT, IFG combined IGT and DM group were 5.6521 ± 4.53 and 13.97 ± 9.84, 7.60 ± 3.85 and 20.59 ± 8.87, 8.90 ± 3.77 and 23.07 respectively ± 8.56, 11.67 ± 5.05 and 26.31 ± 7.87, respectively (P <0.05) .The ROC curves showed that the sensitivity of the single-dose OGTT and two OGTT was 63.8% and 67.3% respectively when the cut-off point of F-DRS was 9, The specificity was 60.8% and 62.7%, respectively. The cut-off points were 6.0 and 6.5 respectively when the sensitivity reached 85%. The sensitivity of single-dose OGTT and two OGTT was C 83.0% and 85.5% respectively, the specificity was 49.1% and 51.0%, and the cut-off point was 19.5 when the sensitivity reached 85%. OGTT was also performed in people with F-DRS ≥ 9, with a diagnostic rate of 67%. 33% missed diagnosis, while 49% of non-DM patients were excluded from OGTT. OGTT was performed on OGTT in C-DRS ≥18 and the diagnostic rate of DM was 85%. Fifteen percent of patients missed diagnosis, while 39% of non-DM patients were OGTT-free. Conclusions There is a good consistency between DRS and IGT. C-DRS is more sensitive than F-DRS and more suitable for first-line screening of DM in Chinese population.