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目的研究中老年人群中糖尿病发病与糖化血红蛋白(HbA1c)基线值的相关性,并分析影响其检测结果的个体因素。方法在2009年通过多阶段分层随机抽样在上海地区调查了3219名≥50岁的上海常住居民。对空腹血糖受损(6.1mmol/L≤空腹血糖<7.0mmol/L)但调查前未被各级医疗机构诊断为糖尿病的调查对象,于2011年通过电话开展糖尿病发病率调查,并检测随访应答对象2009年所留血液样本HbA1c。结果基线人群自报糖尿病发病率为8.6%(278/3219)。2938名非糖尿病人中,空腹血糖受损病例为11%(313/2938)。对其中240名留有电话信息的调查对象于2011年开展电话随访,随访应答率为45%(108/240)。15%(16/108)在2年中新诊断为糖尿病。HbA1c≥6.5%的对象中有50%(6/12)发展为糖尿病,而HbA1c<6.5%的对象中仅有14%(10/72)(OR=6.4,95%CI:1.45～29.06)。多元线性逐步回归分析表明,HbA1c水平和三酰甘油水平呈显著正相关(r=0.176,P=0.026)。结论空腹血糖受损人群糖尿病发病率高于正常人群。基线HbA1c≥6.5%和新发糖尿病显著相关。空腹血糖受损人群应要求检测HbA1c以利于糖尿病的早期诊断和早期治疗。
Objective To study the correlation between diabetes mellitus and baseline HbA1c in the middle-aged and elderly population and to analyze the individual factors that affect the test results. Methods In 2009, 3219 Shanghai residents aged ≥50 years were surveyed in Shanghai by multi-stage stratified random sampling. For those survey subjects with impaired fasting glucose (6.1 mmol / L≤frequency-adjusted fasting glucose <7.0 mmol / L) but not being diagnosed as diabetes by medical institutions at all levels, the incidence of diabetes mellitus was surveyed by phone in 2011 and the follow-up response Subject Blood samples taken in 2009 HbA1c. Results The baseline population reported an incidence of diabetes of 8.6% (278/3219). Among 2938 non-diabetic patients, 11% of impaired fasting glucose was reported (313/2938). Among them, 240 of the respondents who had telephone information were followed up by phone in 2011 with a follow-up response rate of 45% (108/240). Fifteen percent (16/108) were newly diagnosed with diabetes over 2 years. Only 50% (6/12) of subjects with HbA1c≥6.5% developed diabetes and only 14% (10/72) of those with HbA1c <6.5% (OR = 6.4, 95% CI: 1.45-29.06). Multiple linear stepwise regression analysis showed that there was a significant positive correlation between HbA1c level and triglyceride level (r = 0.176, P = 0.026). Conclusion The incidence of diabetes mellitus in people with impaired fasting glucose is higher than that in normal people. Baseline HbA1c ≥ 6.5% was significantly associated with new onset diabetes. People with impaired fasting glucose should be asked to test HbA1c to facilitate the early diagnosis and early treatment of diabetes.