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目的探索适用于无症状2型糖尿病(T2DM)和糖尿病前期(PM)人群筛查策略。方法采用分层整群抽样的方法对广州市番禺区居民进行随机抽样,运用空腹毛细血管血糖(FCBG)、空腹静脉血糖(FPG)、口服75 g葡萄糖2 h血糖(2h PG)、糖化血红蛋白(Hb Alc)等4种实验室指标和中国糖尿病危险因素积分(DRS)问卷对调查对象开展T2DM和PM筛查。采用受试者工作特征曲线(ROC)对5种方法进行比较。结果本研究共完成调查4 264人,女性占73.92%(3 152/4 264);年龄<60岁占63.72%(2 717/4 264);婚姻状况为已婚者占83.51%(3 561/4 264);文化程度以小学为主,占37.99%(1 620/4 264);职业以农民/渔民为主,占37.34%(1 592/4 264)。T2DM和PM检出率分别为10.04%和20.54%。5种方法相比,在单一筛查DM和同时筛查DM和PM时,OGTT的AUC均较大,灵敏度分别为87.851%和97.846%,特异度分别为99.165%和100.000%;其次为FPG和中国DRS问卷。结论 5种筛查方法相比,OGTT筛查效果最好,FPG次之,中国DRS问卷仅次于OGTT和FPG。
Objective To explore screening strategies suitable for asymptomatic type 2 diabetes mellitus (T2DM) and pre-diabetic (PM) populations. Methods A stratified cluster sampling method was used to randomly sample residents in Panyu District of Guangzhou City. The fasting capillary blood glucose (FCBG), fasting venous blood glucose (FPG), oral 2 g glucose (2h PG), glycosylated hemoglobin Hb Alc) and other four laboratory indicators and the China Diabetes Risk Factors Points (DRS) questionnaire survey of T2DM and PM screening. Five methods were compared using the receiver operating characteristic curve (ROC). Results A total of 4 264 persons were surveyed, accounting for 73.92% (3 152/4 264) of women; 63.72% (2 717/4 264) of whom were younger than 60 years; and 83.51% 4 264). Primary education accounted for 37.99% of the total (1 620/4 264). Occupations were mainly farmers and fishermen, accounting for 37.34% (1 592/4 264). The detection rates of T2DM and PM were 10.04% and 20.54% respectively. The AUC of OGTT was higher in single screening DM and simultaneous screening of DM and PM with sensitivity of 87.851% and 97.846%, specificity of 99.165% and 100.000% respectively, followed by FPG and Chinese DRS Questionnaire. Conclusion Compared with the five screening methods, OGTT screening results are the best, FPG second, China DRS questionnaire second only to OGTT and FPG.