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目的探讨HbA1c对于T2DM的诊断价值。方法选取T2DM患者230例,IGR患者130例和糖耐量正常(NGT)者102名,行75gOGTT,同时测定FPG、2hPG、HbA1c等临床指标。结果T2DM组FPG、2hPG高于IGR、NGT组,IGR组FPG与NGT组比较差异无统计学意义。IGR组2hPG高于NGT组。T2DM组HbA1c高于IGR、NGT组(P<0.01),IGR组与NGT组比较差异无统计学意义。Pearson相关性分析显示,HbA1c与FPG、2hPG呈正相关(r=0.698、0.652,P=0.000)。受试者工作特征(ROC)曲线显示,HbA1c≥6.4%为诊断切点的曲线下面积0.922(95%CI:0.899~0.946),HbA1c≥6.4%时与FPG及与2hPG诊断T2DM的曲线下面积比较差异无统计学意义(P>0.05)。结论HbA1c可作为T2DM诊断标准之一,HbA1c≥6.4%为最佳诊断切点。
Objective To investigate the diagnostic value of HbA1c for T2DM. Methods Totally 230 T2DM patients, 130 IGR patients and 102 patients with normal glucose tolerance (NGT) were enrolled in this study. The clinical parameters of FPG, 2hPG and HbA1c were determined simultaneously with 75gOGTT. Results FPG and 2hPG in T2DM group were higher than those in IGR group. There was no significant difference between FPG and NGT group in NGT group and IGR group. IGR group 2hPG higher than NGT group. The level of HbA1c in T2DM group was higher than that in IGR and NGT groups (P <0.01). There was no significant difference between IGR group and NGT group. Pearson correlation analysis showed that HbA1c was positively correlated with FPG and 2hPG (r = 0.698,0.652, P = 0.000). The receiver operating characteristic (ROC) curve showed that the area under the curve of diagnostic cut-off point for HbA1c≥6.4% was 0.922 (95% CI: 0.899-0.946), the area under the curve of FPG and T2H for diagnosis of T2DM with HbA1c≥6.4% The difference was not statistically significant (P> 0.05). Conclusion HbA1c can be used as one of the diagnostic criteria of T2DM, HbA1c≥6.4% is the best diagnostic cutoff point.